BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on March 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Base-Erosion Anti-Abuse Tax (BEAT): The 2017 tax reforms moved the U.S. from a worldwide taxation system to a quasi-territorial system, so foreign earnings are no longer included in a company’s domestic tax base.
To discourage companies operating in the U.S. from avoiding tax liability by shifting profits out of the country, Congress imposed a 10% minimum tax called Base-Erosion Anti-Abuse Tax (BEAT). The BEAT rate will increase from 10% to 12.5% in 2026.
Leverage ratios measure the amount of capital that comes from debt. In other words, leverage financial ratios are used to evaluate a company’s debt levels. Common leverage ratios include the following:
The debt ratio measures the relative amount of a company’s assets that are provided from debt:
Debt ratio = Total liabilities / Total assets
The debt to equity ratio calculates the weight of total debt and financial liabilities against shareholders’ equity:
Debt to equity ratio = Total liabilities / Shareholder’s equity
A common stock is the least senior of securities issued by a company. A preferred stock, in contrast, is slightly more senior to common stock, since dividends owed to the preferred stockholders should be paid before distributions are made to common stockholders.
However, distributions to preferred stockholders are limited to the level outlined in the preferred stock agreement (i.e., the stated dividend payments). Like a fixed income security, preferred stocks have a specific periodic payment that is either a fixed dollar amount or an amount adjusted based upon short-term market interest rates. However, unlike fixed income securities, preferred stocks typically do not have a specific maturity date and preferred stock dividend payments are made from the corporation’s after tax income rather than its pre-tax income. Likewise, dividends paid to preferred stockholders are considered income distributions to the company’s equity owners rather than creditors, so the issuing corporation does not have the same requirement to make dividend distributions to preferred stockholders.
Preferred Stock
Thus, preferred stock is generally referred to as a “hybrid” security, since it has elements similar to both fixed income securities (i.e., a stated periodic payments) and equity securities (i.e., shareholders are considered owners of the issuing company rather than creditors).
Hybrid Securities
Convertible preferred stocks (and convertible corporate bonds) are also considered hybrid securities since they have both equity and fixed income characteristics. A convertible security whether a preferred stock or a corporate bond, generally includes a provision that allow the security to be exchanged for a given number of common stock shares in the issuing corporation. The holder of a convertible security essentially owns both the preferred stock (or the corporate bond) and an option to exchange the preferred stock (or corporate bond) for shares of common stock in the company.
Thus, at times the convertible security may behave more like the issuing company’s common stock than it does the issuing company’s preferred stock (or corporate bonds), depending upon how close the common stock’s market price is to the designated conversion price of the convertible security.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements:
Posted on March 7, 2025 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.
US stocks tanked to session lows on Thursday after more tariff whiplash from the Trump administration.
The Dow Jones Industrial Average (^DJI) fell 1%, or over 400 points, while the S&P 500 (^GSPC) dropped nearly 2%. The tech-heavy NASDAQ Composite (^IXIC) plummeted more than 2.6%. The Nasdaq is now more than 10% off its December record high and officially entered into correction territory.
Trade-war uncertainty has persisted as investors weighed how far President Donald Trump would be willing to negotiate on tariffs. On Thursday, Trump said he would pause tariffs on some Mexican goods, and the White House later said the delay also includes goods from Canada.
Separate Account Management offers medical professionals customized personal money management services. In the typical separate account structure, a money manager invests the individual’s assets in stocks and bonds (as opposed to mutual funds providing exposure to specific asset classes) on a discretionary basis.
For physicians and healthcare providers with significant investment assets (e.g., $100,000), a separately managed portfolio can be customized to reflect their tax situation, social investment guidelines, and cash flow needs.
An additional benefit of the separate account management structure is that a client’s portfolio may be positioned over time as opportunities arise, rather than forcing stocks into the portfolio without regard to current conditions.
Although separate account management generally offers a higher degree of customization than mutual funds, fees for separate account management are generally consistent with mutual funds fees, especially given that separate account managers may discount their fees for larger portfolios.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on March 6, 2025 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.
Endometriosis Awareness Week, which brings attention to the chronic disease that affects about 10% of reproductive-age patients with uteruses worldwide. There’s still no known cure, due in part to research being underfunded—in 2022, the NIH allocated just $16 million, or $2 per patient, to endometriosis research, according to a 2024 study.
After sliding earlier in the session, the tech-heavy NASDAQ Composite (^IXIC) led the gains, rising more than 1.4%. Meanwhile, the Dow Jones Industrial Average (^DJI) and the S&P 500 (^GSPC) rose roughly 1.1%.
Stocks lifted higher after the White House delayed by one month auto tariffs that could significantly impact US automakers Ford (F), GM (GM), and Stellantis (STLA). Shares of all three automakers were at least 5% higher.
The term seed suggests that this is a very early investment, meant to support the business until it can generate cash of its own, or until it is ready for further investments. Seed money options include friends and family funding, seed venture capital funds, angel funding, and crowdfunding.
Types of Seed funding
Friends and family funding: This type of seed funding involves raising money from friends and family members.
Angel investing: As mentioned above, angel investors are wealthy individuals who provide seed funding in exchange for equity ownership.
Seed accelerators: These are programs that provide startups with seed funding, mentorship, and resources to help them grow their businesses.
Crowdfunding: This type of funding allows startups to raise money from a large number of people, typically through an online platform.
Incubators: These are organizations that provide startups with seed funding, office space, and resources to help them grow their businesses.
Government grants: Some government agencies provide seed funding for startups working on specific projects or in specific industries.
Corporate ventures: Some big companies set up venture arms to provide seed funding to startups in their industry or complementary field.
Micro-Venture Capital: A type of venture capital that provides seed funding to new startups and early-stage companies with a small amount of money.
Posted on March 5, 2025 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.
Despite high flu cases, vaccine this season looks overall like a good match. Early season laboratory testing by the CDC suggested this year’s flu vaccine was 100% match for the strain influenza A (H1N1), which accounts for 48% of cases this year, and a 100% match for influenza B, which accounts for just under 3% of cases so far. For targeting influenza A (H3N1), which makes up 49% of cases so far, the CDC said the vaccine is a 51% match.
The Dow Jones Industrial Average (^DJI) fell about 1.5%, or over 650 points, as losses escalated into the close, while the benchmark S&P 500 dropped around 1.2%, hitting its lowest level in four months. The tech-heavy NASDAQ Composite (^IXIC), which traded in the green at one point of the trading day, closed down about 0.4% but was able to avoid entering correction territory.
As in the case of Declinism, to better understand the Forer effect (commonly known as the Barnum Effect), it’s helpful to acknowledge that people like their world to make sense. If it didn’t, we would have no pre-existing routine to fall back on and we’d have to think harder to contextualise new information.
Note: Phineas Taylor Barnum (July 5, 1810 – April 7, 1891) was an American showman, businessman, and politician remembered for promoting celebrated hoaxes and founding with Jim Bailey the Ringling Bros. and Barnum & Bailey Circus. He was also an author, publisher, and philanthropist although he said of himself: “I am a showman by profession … and all the gilding shall make nothing else of me.” According to Barnum’s critics, his personal aim was “to put money in his own coffers”. According to Wikipedia, the adage “there’s a sucker born every minute” has frequently been attributed to him, although no evidence exists that he had coined the phrase
With that, if there are gaps in our thinking of how we understand things, we will try to fill those gaps in with what we intuitively think makes sense, subsequently reinforcing our existing schema(s). As our minds make such connections to consolidate our own personal understanding of the world, it is easy to see how people can tend to process vague information and interpret it in a manner that makes it seem personal and specific to them. Given our egocentric nature (along with our desire for nice, neat little packages and patterns), when we process vague information, we hold on to what we deem meaningful to us and discard what is not. Simply, we better process information we think is specifically tailored to us, regardless of ambiguity.
More specifically, according to colleague Dan Ariely PhD, the Forer effect refers to the tendency for people to accept vague and general personality descriptions as uniquely applicable to themselves without realizing that the same description could be applied to just about everyone else (Forer, 1949). For example, when people read their horoscope, even vague, general information can seem like it’s advising something relevant and specific to them.
Remember, we make thousands of decisions every day, some more important than others. Make sure that the ones that do matter are not made based on bias, but rather on reflective judgment and critical thinking.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Marketability and liquidity are two concepts that are interrelated but often confused by the medical professional. Marketability deals with the speed at which an asset can be turned into cash. Liquidity, on the other hand, deals with an asset that can be turned to cash without a significant loss of value. A physician’s practice may still be good investment, but is it not particularly marketable or liquid. A common stock traded on the New York Stock Exchange can be easily sold for its quoted fair market value.
[B] The Time Value of Money
To the young physician starting a career, the time value of money is not a primary concern. It involves spending dollars in the future compared with spending today. Paying off high student loans while earning a relatively low salary leaves barely enough for present personal consumption. In the past, the rationale to spend today, forsaking the future, was not only a function of necessity but stemmed from the probability that future income would grow appreciably higher. Today, this is no longer a given for medical professionals.
In the simplest terms, a dollar today is worth more than a dollar tomorrow. The supply and demand for a dollar today to be paid back in the future is what determines interest rates. This calls for an understanding of the concepts of present and future value.
Present value is what you have today. So a dollar is a worth a dollar.Future value is what that dollar will grow to when compounded at a given interest rate. If you started with 100 dollars and earned 10 percent for five years, you would end up with 161 dollars.
Year Paying Interest Ending Interest
Amount of Factor Amount (annual)
1 $ 100 1.10 $ 110.00 $ 10.00
2 110 1.10 121.00 11.00
3 121 1.10 133.10 12.10
4 133.10 1.10 146.41 13.31
5 146.41 1.10 161.05 14.64
$ 61.05
Whenever you do not have a financial calculator, such as a Hewlett-Packard 12-C, Texas Instruments BA III plus, apps, SAAS, or computer spreadsheet or handy, you can figure future value with this formula.
FV = PV (1 + i)^N
FV is future value and PV is present value. The periodic interest rate is represented by the i. The number of periods being compounded is the n. The N means to the power of some number. In the example above, the equation would appear as follows:
FV = $100(1+.1)^2
FV = $100(1.21)
FV = $121
N
Likewise, the formula for present value is: PV = amount / (1 + i )
Other time value of money concepts, easily determined with a calculator, or interest table include the future value of multiple (equal) cash flows (ordinary annuity); conversion to an annuity due; the present value of multiple (equal) cash flows (ordinary annuity); and the conversion to an annuity due.
Example: Determining a Funding Amount
Dr. Smith has a daughter who plays the piano very well. He wishes to accumulate funds for his daughter Mackenzie’s advanced music education. He estimates that she will need $6,000 per year in today’s dollars, and will start school at age 18. She is 10 years old now. Costs are expected to increase 6 percent annually. Dr. Smith and his financial advisor believe that he can earn 9 percent after tax on his funds. How much is required?
Step # 1: Determine the future value of $6,000, 8 years from now. Or, what will Mackenzie’s first-year piano school cost, considering inflation?
Using a financial calculator, such as the HP 12-C: @ 8n (years), 6i (interest rate); $ 6,000 PV; the future value is $9,563
Step # 2: Next, determine the lump sum necessary to provide the above amount at the start of each year (present value annuity due).
Again, using the HP12-C @ $9,563 PMT; g7 (PVAD); 4 N; 1.09/1.06 i; the present value is $36, 702.
Step # 3: Compute the annual savings required at the end of each year (ordinary annuity) to provide the lump sum needed at age 18.
Finally, calculate with the HP 12-C @ g8 (ordinary annuity); $ 36,702 FV; 8N; 9i, and solve for PMT = $ 3,328.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on March 4, 2025 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.
Independent pharmacies and pharmacy benefit managers (PBMs) are at odds over a proposed rule change from the Centers for Medicare and Medicaid Services (CMS) over the Medicare Part D program. Pharmacies vs. PBMs
US stocks plummeted on Monday afternoon, as selling accelerated in the last hour of trading after President Trump indicated there was “no room left” for tariff negotiations with Canada and Mexico, with levies against both countries set to go into effect tomorrow.
The S&P 500 (^GSPC) fell 1.7% while the tech-heavy NASDAQ Composite (^IXIC) dropped 2.6%. The Dow Jones Industrial Average (^DJI) fell more than 600 points, or almost 1.5%, as the major US indexes came off a volatile week and a losing February.
Tech led the sell-off with shares of Nvidia (NVDA) tanking more than 8%. All of the “Magnificent 7” stocks declined.
In general, a roadshow is a series of meetings or presentations in which key members of a private company, usually executives, pitch the initial public offering, or IPO, to prospective investors. Effectively, the company is taking its branding message on the road to meet with investors in different cities, hence the name.
The IPO roadshow presentation is an important part of the IPO process in which a company sells new shares to the public for the first time. Whether a company’s IPO succeeds or not can hinge on interest generated among investors before the stock makes its debut on an exchange.
There are also some cases where company executives will embark on a road show to meet with investors to talk about their company, even if they’re not planning an IPO.
Pros and Cons of a Roadshow
According to Rebecca Lake, if the company goes public and no one buys its shares, then the IPO ends up being a flop, which can affect the company’s success in the near and long term. If the company experiences an IPO pop, in which its price goes much higher than its initial offering price, it could be a sign that underwriters mispriced the stock.
A roadshow is also important for helping determine how to price the company’s stock when the IPO launches. If the roadshow ends up being a smashing success, for example, that can cause the underwriters to adjust their expectations for the stock’s IPO price.
On the other hand, if the roadshow doesn’t seem to be generating much buzz around the company at all, that could cause the price to be adjusted downward.
In a worst-case scenario, the company may decide to pull the plug on the IPO altogether or to go a different route, such as a private IPO placement.
If the definition of a security is title to a stream of cash flows, then the dividends a company is expected to pay to equity shareholders on a periodic basis (e.g., quarterly) are a clear source of return for an investor. A dividend is simply a distribution of (some portion of) the company’s earnings to equity shareholders. Like a bond yield, a stock’s dividend yield can be used to measure the income return on the stock.
To determine a stock’s dividend yield, the trailing year’s dividends per share paid are divided by the current stock price. However, a key difference between a dividend yield and a bond yield is the level of certainty that can be assumed regarding future payments, since a bond’s coupon is generally predetermined and its payment is expected to be senior to the payment of dividends.
After a company has determined that it has earned a profit, management has to decide what to do with those profits. One choice is to distribute the earnings to shareholders in the form of dividends, while another option is to reinvest the profits in the company. A company’s management may determine that the shareholders interest is best served by using the earnings to pursue growth opportunities (e.g., capital expansion, research & development, etc.) at the corporate level. Thus, when management believes that its investment opportunities are likely to produce a higher return than what investors’ could generate with their dividends or that reinvestment is needed to maintain its financial strength, the company will retain the earnings.
One of the biggest myths in investing is capital appreciation accounts for the largest part of investors’ gains. Dividends, or cash payments to shareholders, actually account for a substantial part of an equity investor’s total return. In fact since 1926, dividends have accounted for more than 40% of the total return of the S&P 500 stock index. In the last decade (2000-2009), the S&P 500’s total return of -9% would have been a heftier loss of -24% had it not been for the 15% contribution from dividends.
History has shown that dividends have been a powerful source of total return in a diversified investment portfolio, especially during periods of market turbulence. In examining the prior eight decades of stock market performance, dividends often account for more than 2/3 of the total return (1930s, 1940s, 1970s, & 2000s). If an investor avoided dividend paying stocks during these elongated time periods, most of the total gains would be lost.
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DIVIDEND CONTRIBUTION OF S&P 500 RETURN BY DECADE
S&P 500
Cumulative
Dividends
Average
Price %
Dividend
Total
% of Total
Payout
Years
Change
Contribution*
Return
Return
Ratio**
1930s
-41.9%
56.0%
14.1%
>100%
90.1%
1940s
34.8%
100.3%
135.0%
74.3%
59.4%
1950s
256.7%
180.0%
436.7%
41.2%
54.6%
1960s
53.7%
54.2%
107.9%
50.2%
56.0%
1970s
17.2%
59.1%
76.4%
77.4%
45.5%
1980s
227.4%
143.1%
370.5%
38.6%
48.6%
1990s
315.7%
117.1%
432.8%
27.0%
47.6%
2000s
-24.1%
15.0%
-9.1%
>100%
35.3%
2010s
27.9%
8.4%
36.3%
23.1%
28.4%
as of 12/31/12
Source: Strategas
During those decades such as the 2000s where the stock market struggled to advance, dividends were a significant element for investor survival. This is not only due to the dividends alone, but also the risk element of stocks that pay dividends. Dividend stocks have historically provided lower overall volatility and stronger downside protection when markets decline. Since 1927, dividend stocks have consistently held up better than the broader market during downturns. You can measure downside risk through a statistic known as downside capture ratio.
Downside capture ratio is a statistical measure of overall performance in a down stock market. An investment category, or investment manager, who has a down-market ratio less than 100 has outperformed the index during a falling stock market.
For example, a down-market capture ratio of 80 indicates that the portfolio measure declined only 80% as much as the index during the period. The downside capture ratio of high-dividend-yielding stocks, since 1927, has been 81% or lower over various long-term periods. Put a better way, during months that the S&P 500 stock index fell, dividend stocks declined by nearly 19% less than the broader market.
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DOWNSIDE AND UPSIDE CAPTURE RATIOS OF HIGH DIVIDEND STOCKS – 1927 TO 2011
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com
Posted on March 1, 2025 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.
US stocks gained ground Friday following a key inflation reading that largely met expectations and as fresh tariff threats added to uncertainty over Big Tech prospects. The S&P 500 (^GSPC) gained 1.6%%, while the tech-heavy NASDAQ Composite (^IXIC) was up about 1.5% after suffering a Nvidia-led (NVDA) sell-off on Thursday. The Dow Jones Industrial Average (^DJI) climbed 1.3%. All three major averages reversed earlier losses, sending February off with a relief rally.
Markets wrapped the month February with sharp weekly and monthly losses after suffering the buffets of tariff moves. The NASDAQ shed close to 5% in February, while the S&P 500 and Dow suffered drops of around 2%.
Posted on February 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
***
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.
A new bill could change Medicare coverage requirements for Americans across the country. With Medicare was set to run out of funding for telehealth coverage by the end of March, Democratic Representative Ro Khanna of California has introduced the Telehealth Coverage Act to continue the services.
Stocks plummeted on Thursday as tech sold off following Nvidia’s (NVDA) latest earnings report while investors took stock of the economy amid President Trump’s latest tariff pledges.
The S&P 500 (^GSPC) fell more than 1.6%, while the tech-heavy NASDAQ Composite (^IXIC) dropped 2.8%. The Dow Jones Industrial Average (^DJI) dropped 0.4%.
Investors dug into Nvidia’s quarterly earnings beat, which signaled plenty of scope for growth as it eased worries about DeepSeek and faltering AI demand. The results initially met a muted response as its profit outlook raised doubts on Wall Street. Nvidia’s stock erased early morning gains to dropped more than 8%.
Investing in Growth Stocks – Catching the Momentum [BIG-MO]
The growth style of investing focuses on companies with strong earnings and accelerating capital growth. A growth investor will make investment decisions based on forecasts of continuing growth in earnings. Growth investing emphasizes qualitative criteria, including value judgments about the company, its markets, its management, and its ability to extract future earnings growth from the particular industry.
Quantitative indicators of interest to the growth investor include high Price/Earnings ratios, Price/Sales ratios, and low dividend yields. A high P/E ratio suggests that the market is prepared to pay more per share in anticipation of future earnings. A low dividend yield suggests that the company is reinvesting rather than distributing profits. These indicators are considered in relation to the company’s immediate competitors. The companies with the highest P/E ratios relative to their industry will often be dominant within their market segment and have strong growth prospects. Growth investors will generally focus on premium and leading-edge companies.
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Some industry sectors by their nature have stronger growth characteristics, particularly more innovative and speculative industries.
For example, during the bull market run on the U.S. stock markets during the late 1990s, the technology sector was a major area of growth investment. On observing strong earnings growth, a growth investor will decide whether to buy shares based on whether the company’s growth is going to continue at its present rate, to increase, or to decrease. If it is expected to increase, the growth investor will consider it a candidate for purchase. The key research question is: at what point will the company’s growth flatten out, or fall? If a company’s growth rate slows or reverses, it is no longer attractive to a growth investor. Growth investors are normally prepared to pay a premium for what they believe to be high quality shares. The potential downside in growth investing is that if a company goes into sudden decline and the share price falls, you can lose capital value rapidly.
Growth stocks, like the current “Magnificent-Seven“, carry high expectations of above-average future growth in earnings and above-average valuations. Investors expect these stocks to perform well in the future and are willing to pay high P/E multiples for this expected growth. The danger is that the price may become too high. Generally, once a company sports a P/E ratio above 50, the risk significantly escalates. Many technology growth stocks traded at a P/E ratio of above 100 during 1999. This is unsustainable. No company in the history of the stock market has been able to maintain such a high P/E level for a sustained period of time.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on February 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
***
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.
Health experts have expressed conflict of interest concerns after the FDA‘s drug chief quit for a top job in Big Pharma. Pfizer announced this week that Dr. Patrizia Cavazzoni, former director of the FDA’s Center for Drug Evaluation and Research (CDER), will join the company as its chief medical officer.
The tech-heavy NASDAQ Composite (^IXIC) finished the volatile trading day down around 1.3%, dragged down by shares of Magnificent Seven players like Nvidia (NVDA) and Tesla (TSLA). The benchmark S&P 500 (^GSPC) dropped roughly 0.4%, while the Dow Jones Industrial Average (^DJI) reversed earlier session declines to end the day in the green, up about 0.4%.
Some of the biggest market moves also came from the cryptocurrency space, where the price of bitcoin (BTC-USD) tumbled below $90,000 for the first time since November. Bitcoin touched a low closer to $86,000 in the early morning hours, its lowest level since early November. Prices stabilized to just around $88,000 at the market close.
While health care is not “do-it-yourself,” an informed patient can be an asset. A poorly informed patient, on the other hand, clearly complicates treatment. Assume the responsibility of being the primary information source and educator for your patient. To help deal with a self-diagnosing patient, consider the following as suggested by: David B. Troxel, MD, Medical Consultant to The Doctors Company:
Encourage patients to always check with you about the accuracy of information obtained from external sources. Use the intake time to find out what Internet information the patient has found.
Directly discuss what the patient has read, even if the patient’s external source is a good one in your professional opinion. The exchange enhances your relationship with the patient and can increase treatment compliance. Welcome questions, and help put the patient’s information in the appropriate context.
Provide your patient with a list of Web sites that provide accurate information, such as the Centers for Disease Control and Prevention (www.cdc.gov). Make sure the patient understands the limitations of the Internet.
Document in the patient’s chart your diagnosis, your treatment management plan, and medication prescribed, as well as the reasons behind your decisions.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on February 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS
By Staff Reporters
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WASHINGTON, Feb 25 (Reuters) – U.S. President Donald Trump signed an executive order on Tuesday aiming to improve price transparency on healthcare costs by directing federal agencies to strictly enforce a 2019 order he signed during his first term.
The order directs the Departments of the Treasury, Labor, and Health and Human Services to within 90 days come up with a framework to enforce Trump’s 2019 executive order forcing health insurers and hospitals to disclose healthcare cost details.
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This includes requiring the disclosure of actual prices not estimates, update existing guidance or proposing new regulations that ensure price information is standardized, and updating or issuing enforcement policies that guarantee compliance.
“You’re not allowed to even talk about it when you’re going to a hospital or see a doctor. And this allows you to go out and talk about it,” Trump told reporters as he signed the order. “It’s been unpopular in some circles because people make less money, but it’s great for the patient.”
Posted on February 26, 2025 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.
In great news for investors, a new study found that major healthcare companies have paid out $2.6 trillion to shareholders over the past 20 years in the form of dividends and share buybacks, and those payments are increasing. Bad news for patients: Some of that money could’ve been spent on, well, healthcare. The study, published Februrary 10th in JAMA, found that publicly traded S&P 500 healthcare companies paid shareholders a total of $170.2 billion in 2022, up 315% from payouts of just $54 billion in 2001.
The S&P 500 fell 0.5%. The NASDAQ 100 slid 1.2%. A gauge of the “Magnificent Seven” mega-caps sank 2.2%. Nvidia Corp.’s shares slid 2.8% on the eve of the company’s results, while Tesla slumped 8.4% to fall below $1 trillion in market value. The DJIA was up.
Posted on February 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITION
“Show Me the Money”
By Staff Reporters
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In some situations, an inheritance might complicate an estate and add to the estate tax burden. If there are sufficient assets and income to accomplish financial goals, more assets are not needed. A disclaimer may be useful. This is an unqualified refusal to accept a gift or inheritance, that is, when you “just say no”. You have decided not to accept a sizable gift made under a will, trust or other document.
When you disclaim the property, certain requirements must be met:
The disclaimer must be irrevocable;
The refusal must be in writing;
The refusal must be received within nine months;
You must not have accepted any interest in the property; and
As a result of the refusal, the property will pass to someone else.
The property passes under the terms of the decedents will, as if you had predeceased the decedent. If the filer of the disclaimer has control, the property will be included in the disclaimant’s estate and can only be passed to another as a gift for as an inheritance. The intent of the disclaimer is to renounce and never take control of the property.
Posted on February 25, 2025 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.
A grand jury is investigating criminal misconduct at a Silicon Valley fintech firm where customer funds went missing, and has questioned an executive who raised alarms before the company collapsed, people familiar with the matter said. Synapse connected financial technology firms with banks, helping startups that marketed flashy savings apps find a place to park their digital customers’ funds. The middleman managed billions of dollars at its peak, before its sudden collapse in April left thousands of people unable to access their money.
The US Department of Justice is reportedly investigating the insurance giant UnitedHealthcare for its Medicare billing practices. The federal government is examining whether UnitedHealthcare is using patient diagnoses to illegally increase the lump sum monthly payments received through the Medicare Advantage program, according to a report in the Wall Street Journal.
US stocks sold off into the close on Monday as investors weighed the prospects of President Donald Trump’s tariff policies and also shifted focus to this week’s Nvidia (NVDA) earnings.
The Dow Jones Industrial Average (^DJI) was little changed on the heels of its worst week since October. The S&P 500 (^GSPC) fell 0.5%, while the tech-heavy NASDAQ Composite (^IXIC) fell 1.2%.
It has been said that most ordinary people should have at least three to six months of living expenses (not including taxes) in a cash-equivalent reserve fund that is easily accessible (i.e., liquid). The amount needed for a one-month reserve is equal to the amount of expenses for the month, rather than the amount of monthly income. This is because during no-income months there is no income tax.
However, the situation might not be the same for physicians in today’s harsh economic climate.
The New Realities
Now, some physician-focused financial advisors, financial planners and Certified Medical Planners™ suggest even more reserve fund savings; up to two years. That’s because many factors come into play when determining how much a particular doctor’s family should have.
For example:
Does the family have one income or two? If the doctor is in a dual-income family with stable incomes and they live on a single income, the need for a liquid reserve is less.
How stable is the doctor’s income source? If a sole provider with an unstable income who spends all of the income each month, the need for a liquid cash reserve is high.
Does the doctor own the practice, work in a clinic, medical group, hospital or healthcare system? In other words – employee (less control) or employer (more control).
What is the doctor’s medical specialty and how has managed care penetrated his locale, or affected her focus? What about a DO, DDS/DMD or DPM, etc.
How does the family use its income each month; does it have a saver, spender, or investor mentality?
Does the family anticipate the possibility of large expenses occurring in the future (medical practice start-up costs or practice purchase; children, medical school student debts; auto or home loans; and/or liability suits, etc)?
Pan physician lifestyle?
The Past
In the ancient past, a doctor may have opted for a nine-twelve month reserve if the need for security was high – and a six-to-nine month reserve if the need for security was low. But today, even more may be needed. How about 15-18 months, or more? Perhaps even 24 months!
So, the following questions may be helpful in determining the amount of reserve needed by the physician:
1. How long would it take you to find another job in your medical specialty if you suddenly found yourself unemployed – same for your spouse?
2. Would you have to relocate – same for your spouse?
3. How much do you spend each month on fixed or discretionary expenses and would you be willing to lower your monthly expenses if you were unemployed?
Assessment
Once the amount of reserve is determined, the doctor should use the appropriate investment vehicles for the funds.
At minimum, the reserve should be invested in a money market fund. For larger reserves, an ultra-short-term bond fund might be appropriate for amounts over three-six months. While even larger reserves might be kept in a short term bond fund depending on interest rates and trends.
So, what do the initials M.D. really mean? … More Dough!
How much reserve do you have and where is it stashed?
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Marcinko Associates is a financial guide. We help answer your questions in an empowering way. We educate and empower medical colleagues to understand their financial picture and to make better financial decisions. We strive to simplify everything, clear up confusion, and address specific needs and goals.
Whatever your financial situation, we do not shame, criticize, or sell. We enrich, educate and empower. We work with medical colleagues at every stage of their financial journey, through big life personal changes to annual employment reviews, in order to help them understand, invest, and protect their money and autonomy.
And, like the famed ‘Tibetan Sherpas“, we guide physician entrepreneurs from medical practice business plan creation, funding, start-up operations and strategic management improvement to maximize profits and stream-line patient care quality initiatives.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
9. We act with honesty, integrity and are always straightforward. 8. We strive to be innovative, creative, iconoclastic, and flexible. 7. We admit and learn from mistakes and don’t repeat them. 6. We work hard always as competitors are trying to catch up. 5. We treat others with dignity and respect. 4. We are the onus of consulting advice for the well being of others. 3. We fight complacency as former success is in the past. 2. The best management styles are timeless, not timely. 1. Our clients are colleagues and always come first.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on February 22, 2025 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: 700,000. That’s how many “unnecessary and expensive” injections pain management company Pain MD gave patients over eight years, according to court documents in a healthcare fraud case that led to four employees pleading guilty or being convicted. (KFF Health News)
Quote: “A small measles outbreak could be the start of a public health catastrophe that is completely preventable.”—Alok Patel, a pediatrician at Stanford Children’s Health, on why he worries about the current US measles outbreak (ABC News)
U.S. stocks plummeted on Friday on poor economic news. Consumer confidence weakened to the lowest level since November 2023, even as long-run inflation expectations rose to the highest since 1995. The services purchasing managers’ index fell into contractionary territory and January home sales contracted by more than expected.
The Dow Jones Industrial Index plunged by 724 points, or 1.6%, as of 3:30 p.m., the S&P 500 slid 1.6% and the NASDAQ Composite index fell about 2.1%. Adding to the negative sentiment: UnitedHealth fell almost 7% on news of a Justice Department investigation.
A capital call is a notice sent to investors requesting that they contribute additional capital to a private equity fund. Capital calls are made when the fund manager has identified a new investment opportunity that requires additional funds.
Investors must be prepared to respond to capital calls with the required funds in a timely manner, as failure to do so could result in penalties or even the loss of their investment.
Carried Interest: Understanding the Concept
Carried interest is a form of incentive fee paid to private equity fund managers. This fee is calculated as a percentage of the profits generated by the fund’s investments.
Carried interest is often criticized as a tax loophole, as it is treated as capital gains, which are taxed at a lower rate than ordinary income.
Deal Flow: What it Means for Investors
Deal flow refers to the number of potential investment opportunities that a private equity firm evaluates. A robust deal flow is important for private equity firms, as it provides a pipeline of potential investments to consider.
Investors may want to investigate a private equity firm’s deal flow as part of their due diligence process, as a strong deal flow can indicate the firm has a good track record of finding attractive investment opportunities.
Due Diligence: A Key Step in Private Equity Investing
Due diligence is the process of evaluating a potential investment opportunity to assess its viability. This process involves a thorough investigation of the company’s financials, operations, and management team.
Due diligence is a critical step in the private equity investment process, as it helps to identify potential risks associated with an investment opportunity. Investors who skip due diligence do so at their own risk.
Exit Strategy: How Private Equity Firms Make Money
Exit strategy refers to the plan that private equity firms have in place to cash out of their investments. Private equity firms typically exit investments through an initial public offering (IPO), a sale to another company, or a management buyout.
Exit strategy is critical to the private equity investment process, as it is how investors ultimately make returns on their investments.
Fund of Funds: An Overview
A fund of funds is a type of investment fund that invests in other investment funds. In the private equity space, fund of funds typically invest in a portfolio of private equity funds.
Fund of funds can be a good way for investors to gain exposure to a wider range of private equity investments with less risk than investing in individual funds.
General Partner vs Limited Partner: What’s the Difference?
The general partner is the party responsible for managing the private equity fund and making investment decisions. Limited partners, on the other hand, are typically passive investors who provide capital but have little involvement in the investment process.
The distinction between general partners and limited partners is important for investors to understand, as it can impact their level of involvement in the investment process.
Investment Horizon: A Crucial Factor in Private Equity Investments
Investment horizon refers to the length of time an investor plans to hold an investment. In the private equity space, investment horizons can be several years or even a decade.
Investment horizon is a critical factor for investors to consider, as it impacts the level of liquidity they will have and the returns they can expect to make on their investment.
Leveraged Buyout (LBO): Definition and Examples
A leveraged buyout is a type of acquisition where the acquiring company uses a significant amount of debt to finance the purchase. The idea is that the acquired company’s assets will be used as collateral to secure the debt.
Leveraged buyouts can be an effective way for private equity firms to acquire companies with minimal capital investment. However, the use of leverage also increases the risk associated with these types of acquisitions.
Management Fee vs Performance Fee: Understanding the Two
The management fee is the fee paid to the general partner for managing the private equity fund. The performance fee, or carried interest, is paid based on the fund’s performance and returns generated for investors.
The distinction between management fees and performance fees is important for investors to understand, as it affects the level of fees they will be responsible for paying.
Pitchbook: A Guide to Creating an Effective Pitchbook
A pitchbook is a presentation used by private equity firms to pitch their investment strategy to potential investors. An effective pitchbook should be clear, well-organized, and provide a compelling rationale for why investors should consider investing in the fund.
Investors reviewing a fund’s pitchbook should look for evidence of a well-thought-out investment strategy and a track record of successful investments.
Private Placement Memorandum (PPM): What it is and Why It Matters
A private placement memorandum is a legal document provided to potential investors that details the terms of the private equity fund. It includes information on the fund’s investment strategy, expected returns, fees, and risks associated with the investment.
Reviewing a fund’s private placement memorandum is a critical step in the due diligence process, as it provides investors with a comprehensive understanding of the investment opportunity.
Recapitalization: A Strategy for Restructuring a Company
Recapitalization is a strategy used by private equity firms to restructure a company’s capital structure. This can involve issuing debt to pay off equity holders or issuing equity to pay off debt holders.
Recapitalization is often used to improve a company’s financial position and increase its value, making it a key tool in the private equity arsenal.
Valuation Techniques Used in Private Equity Investing
Valuation techniques are used to determine the value of a private company. These techniques can include discounted cash flow analysis, market multiples analysis, and asset-based valuation.
Understanding valuation techniques is important for investors, as it allows them to evaluate the relative value of investment opportunities and make informed investment decisions.
Satisficing is a business decision-making strategy or cognitive heuristic that entails searching through the available alternatives until an acceptability threshold is met.
The term economic satisficing, a portmanteau of satisfy and suffice, was introduced by Herbert A. Simon in 1956, although the concept was first posited in his 1947 book Administrative Behavior. Simon used satisficing to explain the behavior of decision makers under circumstances in which an optimal solution cannot be determined. He maintained that many natural problems are characterized by computational intractability or a lack of information, both of which preclude the use of mathematical optimization procedures.
He observed in his Nobel Prize in Economics speech that “decision makers can satisfice either by finding optimum solutions for a simplified world, or by finding satisfactory solutions for a more realistic world. Neither approach, in general, dominates the other, and both have continued to co-exist in the world of management science”.
“Satisficing” – a made-up word created by combining satisfactory and sufficient – indicates something good, but not great. Like the Canadian single-payer health system, like Medicare-for-All.
Understanding how economic behavior factors into health and health care decisions can benefit anyone interested in this field. However, the following groups of individuals may benefit most from the study of health economics:
Medical providers: Doctors, nurses, and assistants can evaluate new treatments, technologies, and services to determine ways to deliver value-based care. Medical providers benefit from understanding the economics behind these developments [MD/DO, DPM, DDS/DMD, RN, PA, etc].
Administrators: Health care administrators process insurance co-payments and manage financial metrics for health care providers. Learning the intricacies of health care economics can provide the necessary context as they liaise with insurance providers and use new technologies to process payments.
Policymakers or public health officials: Those who are in charge of policy decisions at the local, state, federal, or international levels benefit from understanding the economic relationship between stakeholders and the general public.
Business leaders: Because many Americans receive private insurance, health care becomes a major expense for employers. Business leaders must understand the health economics outlook to appease their employees, shareholders, and even their customers.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on February 21, 2025 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 Dow Jones Industrial Average (^DJI) fell roughly 450 points, or around 1%. The S&P 500 (^GSPC) dropped 0.5%, pulling back after its second record close in a row on Wednesday, while the tech-heavy NASDAQ Composite (^IXIC) also lost about 0.5%.
Worries grew about coming headwinds for corporate America after Walmart beat on quarterly profit but issued cautious 2026 fiscal year guidance. Shares of the retail giant tumbled more than 6%. Walmart’s decline combined with more roughly 4% drops in Goldman Sachs (GS) and JPMorgan (JPM) weighed on the Dow.
Posted on February 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
SAVE A LIFE
By Dr. David Edward Marcinko MBA MEd and Staff Reporters
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Did you know more than 23,000 children experience cardiac arrest outside of the hospital each year?
Learn CPR today so you can be ready and become a part of the Nation of Lifesavers. Because no one, especially our most precious ones, should face a life-changing moment alone.
Posted on February 20, 2025 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.
FDA recently approved the first new kind of painkiller since 1998. The drug, called Journavx and made by Vertex Pharmaceuticals, is a non-opioid medication, and the company says it comes with “no evidence of addictive potential.” One downside? At $15.50 per pill, it’s not cheap, and it’s not clear yet how much insurers will cover.
US stocks closed higher on Wednesday as investors weighed President Trump’s latest 25% tariff salvo and digested the Federal Reserve minutes for insight into future policy.
Wednesday’s minutes from the Fed’s January meeting revealed most central bank officials supported holding policy at restrictive levels amid concerns about persistent inflation.
Posted on February 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
SPONSOR: MarcinkoAssociates.com
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Capital Market: This is a market where buyers and sellers engage in the trade of financial assets, including stocks and bonds. Capital markets feature several participants, including:
Companies: Firms that sell stocks and bonds to investors
Institutional investors: Investors who purchase stocks and bonds on behalf of a large capital base
Mutual funds: A mutual fund is an institutional investor that manages the investments of thousands of individuals
Hedge funds: A hedge fund is another type of institutional investor, which controls risk through hedging—a process of buying one stock and then shorting a similar stock to make money from the difference in their relative performance
Posted on February 19, 2025 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.
US stocks were mixed on Tuesday to begin a holiday-shortened week of trading, with potential policy moves by the Federal Reserve and President Donald Trump in focus.
The benchmark S&P 500 (^GSPC) rose nearly 0.2%, with most of the games coming in the final 10 minutes of trading, to hit a fresh record close of 6,129.58. Meanwhile, the Dow Jones Industrial Average (^DJI) and NASDAQ Composite (^IXIC) finished barely in the green.
Stocks on Wall Street were largely cautious after Monday’s closure for Presidents Day as investors debate the future path of interest rates. Fed officials over the long weekend signaled a firm belief that rates should stay at current levels to combat rising inflation.
Treasury yields stepped higher as investors sought more clues to the chances of rate cuts this year, given recent data failed to give a clear steer. The benchmark 10-year yield (^TNX) rose to trade around 4.54%.
Whether you know it, or not, inflation is your biggest financial and investing enemy. Fortunately, the rule of 70 will tell you in how many years the value of money will be halved.
For example, you just need to divide 70 with the rate of inflation. So if the rate of inflation is 7%, then 70/7 = 10 years. Therefore, in 10 years, your 100 note will be worth 50.
Note: The phrase rule of thumb refers to an approximate method for doing something, based on practical experience rather than theory. This usage of the phrase can be traced back to the 17th century and has been associated with various trades where quantities were measured by comparison to the width or length of a human adult thumb.
Posted on February 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MSFT-HUG Update
By Dr. David Edward Marcinko; MBA MEd
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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.
Today, 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.
In retirement, according to Josephine Nesbit, your economic class can be broadly categorized into four distinct groups, each defined by their net worth and financial capabilities, ranging from retirees with limited resources to the wealthy. And, according to Moneywise, here are the net worth categories of the poor, middle class (and upper-middle class) and rich:
Poor retirees: Poor retirees are in the lower 20th percentile, and may have a net worth of around $10,000. This is often without property ownership, forcing many to rely mainly on Social Security or minimal pensions.
Middle-class retirees: Making up the 50th percentile, with a median net worth of approximately $281,000, this group usually includes home equity, retirement savings and a 401(k) plan.
Upper-middle-class retirees: These retirees possess a net worth between $201,800 and $608,900. They have diversified assets and enjoy a comfortable retirement cushion.
Rich retirees: In the 90th percentile, with net worth starting at $1.9 million, this group has much more financial freedom and is able to afford luxuries and legacy planning.
With international stock markets comprising about 40 percent of the world’s capitalization as of 2023, a broad range of investment opportunities exist outside the borders of the U.S.
For investors who are looking to diversify their mutual fund portfolio with exposure to companies located outside the U.S., there exist two basic choices: A global mutual fund or an international mutual fund.
By definition, international funds invest in non-U.S. markets, while global funds may invest in U.S. stocks alongside non-U.S. stocks.
Make a Choice: The definition may seem clear, but what may seem less clear is why an investor might select one over the other. The reason that an investor may select a global fund is to provide the portfolio manager with the latitude to move the fund’s investments among non-U.S. markets and the U.S. market in order to take advantage of the shifts in relative opportunities these markets may present at any given moment.
By investing in a global fund, the challenge for the investor is that he or she may not know at any point in time their total exposure to the U.S. market within the context of their overall portfolio.
An Inside Look: As a consequence, some investors want to manage their allocation risk by setting the broad asset allocation for their portfolio and then identifying funds that are within those asset classes. For these investors, an international fund may make more sense since it allows them to maintain a greater adherence to their desired domestic/international stock allocation.
Keep in mind that asset allocation is an approach to help manage investment risk. Asset allocation does not guarantee against investment loss. As you consider a global or an international fund, you should also be aware of the fund’s approach to the inherent currency risks. Some funds choose to engage in strategies that may mitigate the effects of currency fluctuations, while others consider currency movements – up and down – to be an element of portfolio performance.
Posted on February 14, 2025 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.
US stocks moved higher on Thursday after President Donald Trump said he plans to introduce reciprocal tariffs as soon as April, while investors digested another report that suggested inflation is once again heating up.
The Dow Jones Industrial Average (^DJI) added more than 0.6%, while the S&P 500 (^GSPC) put on 0.7% after closing lower on Wednesday. The tech-heavy NASDAQ Composite (^IXIC) rose more than 1% as Nvidia (NVDA) and Tesla (TSLA) gained.
Posted on February 13, 2025 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.
Consumer prices overall increased 3% from a year earlier, up from 2.9% the previous month, according to the Labor Department’s consumer price index, a measure of goods and service costs across the U.S. That’s the most since June and above the 2.9% expected by economists surveyed by Bloomberg.
Most U.S. stocks fell Wednesday after a report showed inflation is unexpectedly worsening for Americans.
The S&P 500 dropped 0.3%, though it had been on track for a much worse loss of 1.1% at the start of trading. The Dow Jones Industrial Average sank 225 points, or 0.5%, while the NASDAQ composite edged higher by less than 0.1%
Posted on February 12, 2025 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.
Blue Cross Blue Shield will soon begin paying out $2.67 billion to customers follow a years-long lawsuit alleging that the health insurance giant broke antitrust laws. The litigation began in 2013, when a class-action lawsuit was filed against more than 35 Blue Cross Blue Shield health insurance plans. The lawsuit claims the company broke antitrust laws by limiting market competition, resulting in increased premiums and reduced options for customers.
US stocks closed mixed on Tuesday as investors assessed more tariff policy shifts from President Donald Trump and looked ahead to upcoming inflation data.
Traders also digested the start of Federal Chair Jerome Powell’s two-day testimony in Congress. In his opening remarks, Powell told lawmakers the Fed is not in a rush to adjust interest rates and reiterated the central bank’s stance of not commenting on trade policy.
The Dow Jones Industrial Average (^DJI) edged around 0.3% higher, while the benchmark S&P 500 (^GSPC) closed just above the flatline. The tech-heavy NASDAQ Composite (^IXIC) pulled back about 0.4%.
Accounts payable are short-term obligations to be paid by an organization. It arises from trading activities and other business-related expenses during the business, including parties from whom we have purchased goods or services and costs incurred for which money is yet to be paid, generally in the same financial year.
#2 – Accounts Receivable
Accounts Receivable form part of current assets and refer to amounts due from parties to whom we have sold goods or services or incurred expenses on their behalf for which money is yet to be realized. It may include debtors, bills receivable, etc., which can be converted into cash in the short term to ensure the organization’s liquidity.
#3 – Balance Sheet
A Balance Sheet is a reconciliation of assets (current and fixed) and liabilities (current and noncurrent), and capital invested in an organization. Stakeholders such as creditors, shareholders, and banks, which have granted loans to the organization and government, use the Balance Sheet to analyze the financial position, growth, and stability.
#4 – Current Assets
Current assets refer to an organization’s realizable resources in the short term, generally during the same financial year. They include cash/bank balance and assets that can convert into cash, ranging from short-term loans and advances, sundry debtors, short-term investments, etc.
#5 – Equity
Equity is the amount invested in the business by its owners, in the form of capital in the case of sole proprietorship and partnerships, or shares (equity and preference) of varying denominations in companies (public or private).
#6 – Expenses
All the money outflow (present or future) incurred for procuring goods and services to affect sales in a business (direct expenses) and incidental to the business (indirect expenses) as well as ancillary to the running of an organization are referred to as expenses
#7 – Fixed Assets
Fixed assets are tangible resources that an organization uses for carrying out daily operations of a business, such as land, plant and equipment, furniture and fixtures, buildings, machinery, etc., which are not purchased to be sold in the short term.
#8 – Ledger
Ledger is the book of entry for recording transactions in such a way that we come to know the outstanding debit or credit balance of an account in our business for which we record the opening balance, transactions made in that account, and the closing balance to find out the exact position of that particular account.
#9 – Income Statement
The Income statement forms part of the financial statements and tells us the exact position of our gross and net profit at a particular cut-off date. It is done by recording all the direct incomes and closing stock on the credit side and all direct expenses and opening stock on the debit side to find the gross profit and all the indirect incomes and indirect expenses similarly to find out the net profit.
#10 – Liabilities
Liabilities are the present (short term) and future(long term) obligations of an organization which represents the debts due to be paid for goods and services procured for the business in the past and include sundry creditors, short term loans and advances, bills payable, etc. which come under short term liabilities and debentures, term loans from a bank, long term loans and advances, etc. which come under long term liabilities.
#11 – Net Income
The profit or loss arrived at after deducting all direct and indirect expenses from all the direct and indirect incomes equals to net income made by a business which is the earning done by the business at a cut-off date and is very useful in comparing the growth and financial position of an organization from previous years as well as for adopting measures for the betterment of the profitability levels of the business.
#12 – Revenue
The gross income earned by the organization from carrying out core business activities without deduction of any expenses is termed as revenue earned by the organization, which also indicates the sale and other incomes in total.
#13 – Credit
Wherever an account is credited, it reduces the balance of an account in the case of real accounts, creates an obligation to pay an individual in the case of personal accounts, and increases the income side if a nominal account is credited.
#14 – Debit
Wherever an account is debited, it increases the balance of an account in the case of real accounts, creating an obligation to receive money from an individual in the case of personal accounts and increasing the expenses side if a nominal account is debited.
#15 – Audit
An audit is an examination of books of accounts prepared by an organization to validate the entries recorded and ensure the accuracy and correctness of the financial statements along with finding out any discrepancies in the books, including frauds, if any, hidden by the employees of the organization.
The desire for security and feelings of insecurity are the same thing.
The idea of security, financial or otherwise, is an illusion; human life is inherently insecure. But, this doesn’t mean we shouldn’t be prudent with risk and diligent financial planning with strategies like saving and investing.
However, according to colleague Eugene Schmuckler PhD, MBA,MEd seeking security is like many things; the more you try to grasp and obsess about financial security, the more quickly you will reach a point of diminishing returns. You will feel increasingly less secure at a certain point.
Posted on February 8, 2025 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 U.S. added 143,000 jobs in January, fewer than economists expected, but the unemployment rate inched down to 4% from 4.1%, beating forecasts. Forecasters surveyed by Dow Jones had anticipated 169,000 payroll gains in January, after a surprisingly large 256,000 jump in December.
Last month, the Securities and Exchange Commission said Vanguard would pay more than $100 million to settle charges for misleading statements related to capital gains distributions and tax consequences for retail investors who held Vanguard Investor Target Retirement Funds in taxable accounts.
Major U.S. equities indexes moved lower to close out the trading week as the January jobs report showed slower-than-expected hiring but a down tick in the unemployment rate. Despite the slump in job additions, the overall resilience in the labor market could encourage the Federal Reserve to hold off on additional interest-rate cuts. The S&P 500 and the Dow ended Friday’s session with daily losses of roughly 1.0%. The tech-heavy NASDAQ fell 1.4%.
Most notable this month is the appointment of Tim Noel as the new CEO of UnitedHealthcare after former CEO Brian Thompson was fatally shot in New York City in December.
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Posted on February 7, 2025 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.
US stocks were mixed on Thursday in anticipation of Amazon’s (AMZN) quarterly results, as investors assessed the earnings season so far and eyed President Donald Trump’s fast-moving policy overhaul.
The Dow Jones Industrial Average (^DJI) fell 0.3%. The S&P 500 (^GSPC) rose more than 0.3%, and the tech-heavy NASDAQ Composite (^IXIC) popped 0.5% on the heels of two winning days in a row for the major gauges.
The tariff jitters that shook stocks earlier in the week may have eased, but markets are tracking incoming earnings for any company warnings. At the same time, tech- and chip-related results are being scrutinized for signals about the strength of AI demand.
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Fund managers Tom Bailard, Larry Biehl and Ron Kaiser identified five types of investors, each type characterized by their investment preferences and actions. These 5 types are: Individualists, Adventurers, Celebrities, Guardians and Straight Arrows. Key to the different categories is their different attitude to seeking professional financial advice. Defined below:
Individualists have faith in their own investment abilities so do not approach a financial adviser. But they are also cautious.
Adventurers are what may be called high rollers, in that they like big bets, tend not to diversify and are happy to put all their eggs in one basket. They, too, are unlikely to seek financial advice.
Celebrities tend to follow the crowd in investment terms but are aware of their lack of expertise so frequently consult advisers.
Guardians are fearful of losing money, thus prefer rock-solid investments such as government bonds. They, too, are likely to seek professional investment advice.
Straight Arrows exhibit some of the characteristics of individualists and some of adventurers.
Posted on February 6, 2025 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.
One year after forming an alliance with pharmacy schools, Walgreens says it has taken steps to get more people interested in the profession and improve working conditions at the chain.
Walgreens announced the Deans Advisory Council last February, framing it as a collaboration with pharmacy schools to boost the number of students enrolling and address some of the broader issues in the industry, like burnout and declining reimbursements from pharmacy benefit managers.
US stocks recovered from losses on Wednesday to close higher on the day. Earnings from Alphabet (GOOG, GOOGL) and AMD (AMD) fell short, but Big Tech got a boost from a jump in Nvidia (NVDA) shares.
The tech-heavy NASDAQ Composite (^IXIC) rose 0.2%, while the benchmark S&P 500 (^GSPC) added 0.4%. The Dow Jones Industrial Average (^DJI) led the gains, rising 0.7%, or more than 300 points.
Posted on February 5, 2025 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.
‘There are people with high I.Q.s who have fooled themselves on that one,’ Bill Gates the billionaire Microsoft co-founder told The New York Times. Gates’ comments come as Bitcoin has hit record highs in recent weeks, and the cryptocurrency industry as a whole has hailed the arrival of Donald Trump in the White House as a positive moment.
The President has said he will introduce policies supportive of digital currencies, and both him and his wife Melania launched their own meme coins last month. Cryptocurrency prices took a hit on Monday from the prospect of a trade war between the US and its trading partners, with some well-known digital assets seeing values fall more than 10 percent, AP News reported. However the notoriously volatile investment recovered later on Monday, with Bitcoin rebounding back above $100,000. Gates, who has a net worth of around $165 billion, has previously shared his skepticism around Bitcoin, and its volatility in particular.
US stocks closed higher on Tuesday, led by Big Tech, as investors assessed China’s instant retaliation to US President Donald Trump’s additional tariffs and the potential risks of a trade war.
Traders also took in fresh jobs data, with job openings declining more than expected in December. Investors are continuing to watch any signs of cooling in the labor market as the Federal Reserve debates future interest rate cuts in the face of sticky inflation.
The Dow Jones Industrial Average (^DJI) gained around 0.3%, while the benchmark S&P 500 (^GSPC) rose roughly 0.7%. The tech-heavy NASDAQ Composite (^IXIC) jumped nearly 1.4% to recoup some of Monday’s losses.
Beijing reacted swiftly on Tuesday to Trump’s additional 10% levies on Chinese imports going into effect at midnight. China slapped tariffs of 15% on US coal and liquified natural gas, starting Feb. 10, alongside 10% duties on imports of crude oil, farm equipment, and some autos.
Posted on February 4, 2025 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.
Just moments after he was appointed by President Donald Trump to be the new acting director of the Consumer Financial Protections Bureau, Treasury Secretary Scott Bessent moved to halt the agency’s work investigating financial abuses and regulating deceptive banking practices impacting American consumers, according to a memo sent to employees and obtained by Scripps News.
This year is expected to be busy with healthcare mergers and acquisitions (M&A).Consulting company PwC reported that annual healthcare deals shot up 70% through November 15th compared to pre-Covid trends, and projected the trend will continue into 2025.
US stocks fell on Monday in reaction to the Trump administration’s scheduled tariff rollout against Canada and China, though the major averages pared heavier losses after President Donald Trump said the US would delay duties on Mexican imports by a month.
The tech-heavy NASDAQ Composite (^IXIC) closed down 1.2%, recouping a chunk of its earlier losses. Meanwhile, the S&P 500 (^GSPC) fell roughly 0.7%, and the Dow Jones Industrial Average (^DJI) fell 0.3%.
Book Dr. David E. MarcinkoMBA MEd CMPfor your Next Medical, Pharma or Financial Services Seminar orPersonal and Corporate Coaching Sessions
Dr. Marcinko 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.
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