BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on December 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The European Union Paradox is the perceived failure of European countries to translate scientific advances into marketable innovations.
The root of this issue remains debated: is it due to the scientific output being distant from the cutting-edge, or is it because the European innovation system lacks the capacity to harness the potential of groundbreaking research?
And so, this study reveals that, compared to similar European research, the European Research Council has a similar probability of being cited in patents, although it garners a larger number of patent citations. Moreover, patents that do draw upon ERC research are often of superior quality, measured by forward citations.
Compared to similar European research, inventive activities arising from ERC science are predominantly housed within universities and public research organizations. In absolute terms, however, US organizations, especially US companies, still lead in deriving the greatest benefit from ERC science.
Posted on December 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stat: 97%. That’s how many healthcare leaders think A.I. will become important in healthcare over the next five years.
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Pharmacy benefit managers (PBMs) are once again under pressure from federal leaders. A group of Democratic and Republican congresspeople proposed legislation that would attempt to prevent pharmacies from also owning PBMs. The three largest PBMs—CVS Health’s Caremark, Cigna’s Express Scripts, and UnitedHealth Group’s Optum Rx—currently operate pharmacies and administer more than 80% of the prescriptions in the US, and officials have linked this practice to drug price increases.
US stocks fell across the board on Tuesday, with the Dow logging its biggest losing streak in 46 years. The Dow Jones Industrial Average (^DJI) finished the session down roughly 0.6%, registering its ninth straight day of losses. The last 9-day losing streak for the Dow was Feb. 1978. Prior to that, the index suffered an 11-day losing streak in 1974 and another in 1971.
The other major indexes dropped in tandem on Tuesday, with the benchmark S&P 500 (^GSPC) falling around 0.4% and the NASDAQ Composite (^IXIC) losing about 0.3% after the tech-heavy index closed at a record high on Monday.
Posted on December 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
U.S. stocks closed mostly higher Friday, with the S&P 500 and NASDAQ Composite each notching fresh record peaks after the latest employment report showed jobs growth bounced back in November. The S&P 500 rose 15.16 points, or 0.2%, to end at 6,090.27. The NASDAQ climbed 159.05 points, or 0.8%, to close at 19,859.77. The Dow Jones Industrial Average fell 123.19 points, or 0.3%, to end at 44,642.52.
Two years ago, prior to the 2022 election, mental health experts alerted the medical world to their version of an assessment scale for yet another new condition – “doomscrolling.”
As defined by the National Library of Medicine in the article, “Constant exposure to negative news on social media and news feeds could take the form of ‘doomscrolling’ which is commonly defined as a habit of scrolling through social media and news feeds where users obsessively seek for depressing and negative information.”
And so, formally Doomscrolling or doomsurfing is the act of spending an excessive amount of time reading large quantities of news, particularly negative news, on the web and social media. Doomscrolling can also be defined as the excessive consumption of short-form videos or social media content for an excessive period of time without stopping. The concept was coined around 2020, particularly in the context of the COVID pandemic.
Surveys and studies suggest doomscrolling is predominant among youth. It can be considered a form of internet addiction disorder. In 2019, a study by the National Academy of Sciences found that it can be linked to a decline in mental and physical health. Numerous reasons for doomscrolling have been cited, including negativity bias and FOMO [fear of missing out], and attempts at gaining control over uncertainty.
QUERY: What about the roaring stock market, post the 2024 presidential election. Fundamental analysis or FOMO?
Posted on November 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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In a sign of legislative momentum, 41 senators are supporting efforts to prevent a pending 2.8 percent cut in Medicare physician payments that will go into effect January 1st. The bipartisan letter led by Sens. John Boozman, R-Ark., and Peter Welch, D-Vt., to Senate leaders says the cuts would interfere with the ability of physicians to provide high-quality care. “These continued payment cuts undermine the ability of independent clinical practices – especially in rural and under served areas – to care for their communities,” the letter said.
The Senate letter follows one from the American Medical Association (AMA) and 127 other state medical associations and national medical societies asking Congress to use these last few congressional days to prevent the scheduled cuts. The letter to congressional leaders also urges Congress to provide a positive payment update for 2025. All 50 state medical societies – and DC— as well as 77 national medical societies signed.
Posted on November 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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According to HVL from Morning Brew, a new survey from financial services company Empower ignited a conversation about what monetary success means. Turns out, it depends on who you ask. Boomers believe that success means having an annual salary of about $100,000. Gen Z thinks your mom can’t brag about you to her dentist until you earn $600k/year. On average, respondents said success is making $270,000 annually.
Additionally, less than 40% of respondents said they considered themselves financially successful. Almost 50% don’t believe they will achieve the level of success they desire.
But there was some good news: Forty-three percent said their idea of success didn’t depend on a specific sum of money. And almost 60% said happiness is most important, as long as happiness is defined as “being able to spend money on the things and experiences that bring the most joy.”
Posted on November 26, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The Commonwealth Fund’s 2024 biennial health insurance survey, released November 21, found that though 79% of US adults had continuous health insurance for 12 months, 23% were under insured, meaning they have health insurance and still can’t afford care. About 56% of those surveyed had adequate insurance coverage all year.
Flying taxi company VerticalAerospace popped 45.51% after announcing an additional $50 million in funding from one of its biggest shareholders.
STOCKS DOWN
Defense contractor stocks got a double whammy today: Hopes of a ceasefire between Israel and Hezbollah, combined with Elon Musk’s declaration on X that buying manned military aircraft is wasteful. LockheedMartin fell 3.76%, NorthropGrumman dropped 2.39%, and Raytheon Technologies parent company RTX Corp. fell 1.74%.
Speaking of Musk, Tesla sank 3.96% after California announced it may exclude the automaker from incentives that encourage drivers to buy EVs in the state.
Pipeline operator Oneok lost 4.72% on the news that it will acquire the remaining portion of EnLink Midstream that it doesn’t already own.
After rallying last week thanks to its inclusion in the S&P 500, Texas Pacific Land sank 6.71% today as investors took profits.
The SPX rose 18.03 points (0.30%) to 5,987.37; the $DJI added 440.06 points (0.99%) to 44,736.57; and the NASDAQ Composite®($COMP) gained 51.18 points (0.27%) to 19,054.84.
The 10-year Treasury note yield fell 15 basis points to 4.27%.
The CBOE Volatility Index® (VIX)dropped to 14.74, the lowest since November 14.
Posted on November 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Tobacco bonds are a form of municipal debt securities and securitized debt whose payment obligations are tied to a master medical lawsuit settlement agreement between 46 states and several major U.S. tobacco companies.
In exchange for the states settling their lawsuits against the tobacco industry for recovery of tobacco-related health care costs and exempting the tobacco companies from private tort liability regarding harm caused by tobacco use, the companies agreed to curtail or cease certain tobacco marketing practices and to pay, in perpetuity, various annual payments to the states to compensate for the medical costs of tobacco-related illnesses.
These tobacco industry payments have been securitized into municipal bonds. One underlying risk, among others, is that if certain conditions are met, the tobacco companies may reduce or suspend part of their payments.
Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Dr. David Edward Marcinko MBA MEd
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The number of people living with Alzheimer’s disease is growing. The ripple effect is straining families, communities, and the healthcare system, yet talking about the disease on a personal level can be difficult.
November is Alzheimer’s Awareness Month because it can happen in any family, and because it’s worth talking about the challenges of living with or caring for someone with this disease.
You may notice splashes of teal and purple sprouting up this November, as both colors are associated with Alzheimer’s awareness. Teal is the color of the Alzheimer’s Foundation of America, chosen for its calming effect. Purple is the signature color of the Alzheimer’s Foundation, which stands for strength in the fight against Alzheimer’s disease.
Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Doctors, Facing Another Pay Cut, Call for Permanent Medicare Payment Reform
The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. CMS has finalized the calendar year 2025 Medicare Physician Fee Schedule rule that sets payment rates for next year and also outlines new policies focused on primary care, preserved telehealth flexibilities, and a strengthened Medicare Shared Savings Program (MSSP).
But, provider groups were quick to condemn CMS’ decision to go ahead with the pay cut, which was proposed in the draft rule released in July. In a statement, Bruce Scott, MD, president of the American Medical Association (AMA), pointed out that that while physicians are receiving a 2.8% payment cut next year, medical practice costs for physicians will increase by 3.5% in 2025. After adjusted for inflation, Medicare reimbursement to physicians has decreased 29% since 2001, the AMA says.
Classic Definition: Despite rising costs, health care often is of poor quality. Evidence from a classic medical improvement outcomes study assessed care of patients with several chronic diseases. This study found that patients’ functional health status outcomes are similar to care rendered by specialists and generalists but that generalists use far fewer resources. Similar outcome at lower cost represents higher value.
Modern Circumstance: Current solutions to improving care quality may do more harm than good if they focus more on diseases than on people. Efforts to improve the parts (evidence-based care of specific diseases) may not necessarily improve the whole (the health of people and populations).
Expanding access to specialty care, for example, has been proposed as both a source of and a solution for deficiencies in quality of care. Primary care is touted as an essential building block of a high-value health care system even as it is undermined by systems attempting to improve the quality, effectiveness, and value of their health care..
Paradox Example: The above contradictions plague improvement efforts in health care systems around the world, particularly the United States The paradox is that compared with specialty care or with systems dominated by specialty medical care, primary care is associated with the following: (1) poorer quality care for individual diseases, yet (2) similar functional health status at lower cost for people with chronic disease, and (3) better quality, better health, greater health equity and lower costs for whole peoples and populations.
And so, this contradiction plagues improvement efforts in health care systems around the world, particularly the United States.
Classic: Investment purchases and private expenditures of healthcare firms, the value of related construction, and the change in inventory during the year.
Modern: Gross Revenue Per Day is the average amount charged by a hospital for one day of inpatient care (gross inpatient revenue divided by patient-census days).
Gross Revenue Per Discharge: The average amount charged by a hospital to treat an inpatient from admission to discharge (gross inpatient revenue divided by discharges).
Gross Revenue Per Visit: The average amount charged by a hospital for an outpatient visit (gross outpatient revenue divided by outpatient visits).
Posted on November 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Nvidia is replacing Intel on the Dow Jones Industrial Average, a shakeup to the blue-chip index that replaces a flagging semiconductor company with the primary vendor of GPUs for AI.
Bipartisan Legislation Aims to Stop Medicare Cuts & Boost Physician Pay in 2025
Physicians and other healthcare practitioners may get a pay boost in 2025 through a bipartisan bill recently introduced in Congress. The proposed bill seeks to block planned Medicare pay cuts next year and would provide the first inflationary update to physician pay in years. The Medicare Patient Access and Practice Stabilization Act would counteract the 2.8% cut to the conversion factor proposed by the Centers for Medicare and Medicaid Services (CMS) in the draft CY-2025 Physician Fee Schedule. A stop-gap pay fix is usually enacted by Congress at the end of the year.
Source: Emma Beavins, Fierce Healthcare [10/30/24].
In-network refers to a health care provider that has a contract with your health plan to provide health care services to its plan members at a pre-negotiated rate. Because of this relationship, you pay a lower cost-sharing when you receive services from an in-network doctor.
What does out-of-network mean?
Out-of-network refers to a health care provider who does not have a contract with your health insurance plan. If you use an out-of-network provider, health care services could cost more since the provider doesn’t have a pre-negotiated rate with your health plan. Or, depending on your health plan, the health care services may not be covered at all.
Classic: Any medical provider, supplier or facility that is in-network is one that has contracted with your health insurer to provide services;as above.
Modern: Depending on your plan, if you visit an out-of-network provider, it may not be covered or might be only partially covered. When making appointments with various doctors and service providers, you may notice some are listed as “in-network” while others are “out-of-network.”
THINK: Medicare Advantage {Part C] Plans
Example: You can expect a higher deductible and out-of-pocket limit at out-of-network providers. Your coinsurance and co-payment may also be higher for out-of-network providers.
Classic Definition: Employers write checks that cover most health insurance premiums for employees and their dependents. But as the late Princeton health economist Uwe Reinhardt PhD once explained, employer-sponsored insurance is like a pickpocket taking money out of your wallet at a bar and buying you a drink. You appreciate the cocktail until you realize you paid for it yourself.
Modern Circumstance: With health coverage, employers write the check to the insurer, but employees bear the cost of the premium — the entire premium, not just the portion listed as their contribution on their pay stub. The premium money that goes to the insurance company is cash that employers would otherwise deposit in employees’ accounts like the rest of their salary.
Paradox Example: The fallacy paradox is in thinking an employer’s contribution comes out of profits. In fact, higher health insurance premiums mean lower wages for workers. Since 1999, health insurance premiums have increased 147 percent and employer profits have increased 148 percent. But in that time, average wages have hardly moved, increasing just 7 percent. Clearly workers’ wages, not corporate profits, have been paying for higher health insurance premiums. Health care costs are one — though not the only — reason wages have stagnated over the last few decades. With health insurance costs rising faster than growth in the economy, more labor costs go to benefits like health insurance and less to take-home pay. Yet the paradox that employees don’t pay for their own health insurance is widespread:
The first reason is that individuals cannot be sure what causes their wages to change or remain stagnant for decades.
The second reason is that employers want Americans to believe that they pay for their workers’ health insurance.
The third reason is that there are those who profit from the employment-based system: drug companies, device manufacturers, specialty physicians and high-income individuals.
And so, they all want you to believe companies are being magnanimous in giving you insurance, but they are not!
Posted on October 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Markets: The S&P 500hit an all-time high yesterday, closing out its sixth consecutive week of gains for its longest streak of 2024. The Dow and NASDAQ also closed in the green.
The largest Medicare Advantage insurers have prioritized profits over patient care by increasing the use of prior authorization in recent years to frequently deny post-acute care services to older adults, according to a report published Oct. 17th by the Senate Permanent Subcommittee on Investigations.
The drugstore chain CVS is in the process of shuttering “roughly 300” locations across the country in 2024, a spokesperson confirmed to Good Housekeeping. That includes the dozens of pharmacies in Target stores.
Posted on October 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Are doctors using publicly available tools like ChatGPT? The answer, Fierce Healthcare finds, is yes. In the first in-depth look of its kind into physician use of public genAI tools, Fierce Healthcare spoke with nearly two dozen doctors, students, AI experts and regulators, and helped conduct a survey of more than 100 physicians. The reporting confirms that some doctors are turning to tools intended for non-clinical uses to make clinical decisions.
A collaborative survey between Fierce Healthcare and physician social network Sermo found that 76% of respondents reported using general-purpose LLMs in clinical decision-making. With no standardized guidelines, lagging physician training and regulators racing to try to keep up with rapidly changing technology, guardrails to protect patients appear to be years behind current rates of utilization.
Posted on October 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters &The Medicare Team
Medicare open enrollment—which runs from October 15th through December 7th this year—is your chance to check in on your Medicare plan and, if needed, change it.
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Mark your calendars — Medicare Open Enrollment starts October 15th! Did you know new benefits are coming to Medicare drug coverage next year?
Also starting next year, you can choose to participate in a program that spreads your out-of-pocket drug costs across the calendar year, instead of paying all at once at the pharmacy. It’s called the Medicare Prescription Payment Plan — and you can opt in with your plan throughout the 2025 plan year. Contact your plan for more details.
Remember, Medicare plans can change from one year to the next, and so can your health needs. Preview and compare all your health and drug options and see if you can save!
Posted on October 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
COMMON SENSE PUBLIC AND POPULATION HEALTH
By Staff Reporters
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According to colleague Dan Ariely PhD,Disease Avoidant Behavior are the actions we take to avoid illness, often driven by instinctive or learned responses. It’s why we wash our hands obsessively during flu season, wear a balaclava mask and/or avoid people who are sneezing or coughing.
Note: A balaclava is a form of cloth headgear designed to expose only part of the face, usually the eyes and mouth. Depending on style and how it is worn, only the eyes, mouth and nose, or just the front of the face are unprotected. Versions with enough of a full face opening may be rolled into a hat to cover the crown of the head or folded down as a collar around the neck.
This behavior is rooted in our evolutionary survival instincts, helping us steer clear of contagious health threats like RSV, COVID and the winter flu. While it’s usually a good thing, excessive disease avoidant behavior can lead to anxiety and social isolation.
So, balance caution with common sense and public/population health directives to stay healthy and sane.
Posted on October 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The Consumer Price Index rose 2.4% in the 12-month period that ended in September, while a gauge that strips out food and energy prices was 3.3%, the government said yesterday.
Stat: 7%. That’s how much employer health insurance premiums increased this year, after rising by the same margin last year. Family coverage this year costs roughly $25,500 for employers and employees. (the Wall Street Journal)
Celsius Holdings, makers of those disgusting energy drinks your 12-year-old cousin chugs, soared 14.42% after analysts from Stifel and Piper Sandler gave it a vote of confidence.
Crowdstrike enjoyed a rare bump 5.56% higher today after RBC Capital analysts named the company one of the top software stocks of 2025. Speaking of, Delta Air Lines announced it took a $380 billion hit last quarter due to the Crowdstrike outage. Shares of the airline sank 1.16% after earnings.
CVS Health rose 1.35% after an upgrade from Barclays analysts who think the company’s Medicare business should recover nicely.
GXO Logistics, a supply-chain management company, popped 14.11% on a report from Bloomberg that the company is exploring a potential sale.
Stocks down
10X Genomics, which sounds like the bad guys that accidentally release a military-grade virus in a zombie movie, fell 24.70% after it announced preliminary results that disappointed shareholders.
Toronto-Dominion Bank dropped 5.29% on the news that not only will the Canadian bank pay US regulators $3 billion in penalties, but its retail business growth will be limited in the US. All that for failing to stop drug cartels from laundering money.
First Solar sank 9.29% after Jefferies analysts cut their price target on the solar power panel maker, citing production delays hurting the company’s bottom line. The report sent shares of competitors Enphase Energy and SolarEdge Technologies tumbling 5.82% and 4.32%, respectively.
PayPal lost 3.27% thanks to a report from Bernstein analysts who downgraded the stock on fears that Venmo could lose market share to competitors.
The S&P 500® index (SPX) lost 11.99 points (–0.21%) to 5,780.05; the Dow Jones Industrial Average® ($DJI) fell 57.88 points (–0.14%) to 42,454.12; and the NASDAQ Composite® ($COMP) dropped 9.56 points (–0.05%) to 18,282.05.
The 10-year Treasury note yield (TNX) rose three basis points to 4.1%, the highest since July 31 and closing in on the 100-day moving average.
The CBOE Volatility Index® (VIX) was flat at 20.87.
PepsiCo cut its full-year organic revenue guidance as consumers reduced their spending on drinks and snacks, and the company posted “its second straight quarter of weaker-than-expected sales,” CNBC reported.
Posted on October 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
DUMB PHONES ANYONE?
By Anonymous Reporter[s]
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Allow us [me] to suggest the use of Android and iOS shortcuts that disable bio-metric unlocking on your cell phone.
“If you use a bio-metric phone sensor [eye scan or fingerprint], you can be compelled to decrypt your device for law enforcement because a bio-metric is something you are,” lawyer Riana Pfefferkorn said in a 2019 talk at the Defcon security conference.
But, “If you use a pass-code to decrypt, typically, you can’t be compelled to unlock, because a pass-code is something that you know.” Her talk did not cover how claiming to have forgotten a pass-code would affect those issues.
In either case, if your cell phone becomes in possession of federal investigators, you may faces the risk of them determining the unlock code through other means, like using such third-party tools as Cellebrite’s unlocking kits to defeat the phone’s security.
Stay Legal! Or simply invoked your Fifth Amendment right against self-incrimination; if needed.
In conclusion: I [we] advise the awareness of cell phone privacy risks involved in having so much of your life stored on personal smart cell phone devices that you take almost everywhere. Stay Safe!
Posted on May 5, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
SDOH
By Staff Reporters
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READ: Social determinants of health aren’t just for patients. Health systems looking to promote health equity within their communities can start internally, by looking at their own workforce; according to HealthcareBrew.