BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on May 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITION
By Staff Reporters
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Classic: Despite a wide variety of empirical methods and data sources, the demand for health care is consistently found to be price inelastic
Modern: If you are sick, you will not be very price sensitive. There are exceptions to this rule (e.g., elective surgery such as plastic surgery, purchases of eyeglasses) but most studies find that patients are fairly insensitive to changes in health care prices.
Examples: For instance, the RAND Health Insurance Experiment found that the price elasticity of medical expenditures is -0.2.
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The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
Posted on May 3, 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: $1.5 billion. That’s how much a lawsuit alleged hospitals lost because of under funding for facilities serving low-income patients. The Supreme Court ruled against the push for more reimbursement. (Healthcare Dive)
Read: An exclusive interview with Marty Makary, the newly appointed FDA commissioner, on cuts, vaccines, and his future goals. (MedPage Today)
MicroStrategy climbed 3.35% despite reporting a bigger EPS loss than expected. Shareholders must have liked hearing CEO Michael Saylor call the company the Domino’s Pizza of crypto.
Maplebear, which does business as Instacart, rose 13.62% after missing analyst estimates but issuing strong fiscal guidance for the coming quarter.
Dexcom popped 16.17% on strong earnings for the glucose monitor manufacturer.
Wolfspeed exploded 23.89% higher as shareholders cheered the departure of the semiconductor stock’s CFO and a short squeeze took traders by surprise.
What’s down
Take Two Interactive Software tumbled 6.66% after the video game maker announced the release of its highly anticipated Grand Theft Auto 6 will be delayed until next May.
Posted on May 2, 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.
Meta Platforms jumped 4.23% after the big tech giant reported that its advertising revenue came in at $41.39 billion, beating analyst projections of $40.44 billion, thanks to higher ad price growth than expected. Daily active users rose to 3.43 billion, up from 3.35 billion last quarter, while nearly 1 billion people use its digital AI assistant every month. Management expects Q2 sales to come in between $42.5 billion and $45.5 billion, in-line with analyst forecasts of $44.03 billion.
EPS: $6.43 per share, crushing estimates of $5.28
Revenue: $42.31 billion, above the $41.10 expected
Microsoft leaped 7.63% after reporting its profit jumped a staggering 18% from a year earlier. That wasn’t the only good news: Revenue from Microsoft’s Azure cloud software grew 33% year over year, higher than the 31% expected by analysts. But perhaps the best news of all was management’s upbeat guidance—Microsoft projected revenue between $73.15 billion and $74.25 billion for the current quarter, well above expectations of $72.26 billion.
EPS: $3.46 per share, beating forecasts of $3.22
Revenue: $70.07 billion, above the $68.42 billion projected
Eli Lilly dropped 11.66% today, despite the fact that the pharmaceutical giant reported that sales skyrocketed 45% year over year thanks to its lucrative GLP-1 drugs, Zepbound and Mounjaro. Two things spooked investors today: The company lowered its profit outlook well below its preview estimate due its acquisition of a cancer drug from Scorpion Therapeutics, and CVS Health dropped Zepbound from its preferred drug list in lieu of arch-rival Novo Nordisk’s Wegovy this morning.—LB
EPS: $3.34 adjusted, beating the $3.02 expected
Revenue: $12.73 billion, compared to the $12.67 projected
Carrier Global climbed 11.61% after the air conditioning company boosted its fiscal forecast. Turns out everyone needs AC regardless of economic uncertainty.
People also need straight teeth: Dental products manufacturer Align Technology rose 1.98% on solid earnings.
Quanta Services gained 9.99% after the construction engineering company beat Wall Street estimates on both the top and bottom line.
What’s down
Qualcomm may have beaten earnings expectations, but shares fell 8.92% after investors were disappointed by the chipmaker’s lower guidance.
GM was in the same boat: Earnings beat forecasts, but poor guidance and warnings that tariffs could cost the company up to $5 billion this year pushed shares 0.42% lower.
Robinhood Markets enjoyed a 50% increase in revenue last quarter as traders played the volatile market, but the stock still sank 5.07%.
Moderna fell 5.29% after the vaccine maker missed revenue expectations and said it’s planning another $1.5 billion in cost cuts.
Church & Dwight, maker of household goods like Arm & Hammer Baking Soda, missed revenue forecasts last quarter and sank 6.87%.
Becton Dickinson & Co. lost 18.13% after the medical device maker warned of the adverse effects of, what else, tariffs.
Posted on May 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.
Caterpillar eked out a 0.54% gain after raising its fiscal 2025 revenue forecast, but the construction giant warned that it will eat about $350 million in extra tariff-related costs.
What’s down
Super Micro Computer plunged 11.50% after reporting terrible preliminary earnings and warned of weaker results still to come.
Etsy beat revenue expectations last quarter, but fell 5.74% after missing profit forecasts as the number of buyers and sellers using its platform continued to fall.
Snap tumbled 12.43% after the social media stock warned that economic uncertainty could hurt its advertising business and refused to issue a fiscal forecast.
Chili’s parent company BrinkerInternational fell 1.89% despite posting solid earnings as investors worry about slowing consumer spending.
Norwegian Cruise Line sank 7.77% after missing earnings and warning of a slowdown in demand.
Stat: $228 million. That’s how much Sacramento-based Sutter Health—one of the largest health systems in the US—agreed to pay to settle allegations of inflating insurance premiums. (Reuters)
Read: Here’s what some say the new Medicare director, a former tech CEO, is likely to focus on. (Stat)
Posted on April 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
FUNDAMENTAL INDUSTRY CHANGES
By Staff Reporters
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Index Funds
An index mutual fund or ETF (exchange-traded fund) tracks the performance of a specific market benchmark—or “index,” like the popular S&P 500 Index—as closely as possible. That’s why you may hear people refer to indexing as a “passive” investment strategy.
Instead of hand-selecting which stocks or bonds the fund will hold, the fund’s manager buys all (or a representative sample) of the stocks or bonds in the index it tracks.
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Quantum Computing
Unlike traditional computers that use bits, quantum computers utilize qubits. These qubits are capable of being in a state of superposition, where they can represent both 0 and 1 simultaneously, enabling the processing of multiple calculations at once. This could allow quantum computers to outperform classical computers in solving certain complex problems. However, the field is still overcoming challenges such as qubit stability and decoherence; especially in these three areas:
Quantum computing could fundamentally alter healthcare by accelerating drug discovery and improving individualized medicine. Rapid analysis of enormous volumes of biological data allows quantum computers to find trends that might guide the creation of more potent treatments. In addition to accelerating drug development, this will enable customized treatments tailored to unique genetic profiles.
Faster and more accurate financial models produced by quantum computing will transform the banking sector. Through real-time analysis of intricate financial systems, it can help investors to control risk and make better decisions. More precise market forecasts will help maximize portfolio management and trading strategies.
Through greatly enhanced medical diagnosis and patient care, quantum computing can transform the healthcare industry. Quantum computers can remarkably accurately find trends and possible health hazards by analyzing enormous volumes of medical data in a fraction of the time. Early diagnosis and more customized treatment alternatives follow from this.
B–QTUM Index Fund
Index Description: The BlueStar® Machine Learning and Quantum Computing Index (BQTUM) tracks liquid companies in the global quantum computing and machine learning industries, including products and services related to quantum computing or machine learning, such as the development or use of quantum computers or computing chips, superconducting materials, applications built on quantum computers, embedded artificial intelligence chips, or software specializing in the perception, collection, visualization, or management of big data.
Posted on April 30, 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.
Coca-Cola rose 0.84% after the beverage behemoth beat earnings expectations. Not only that, it also doubled down on its forward-looking guidance, saying that revenue will grow 5% to 6% while comparable earnings per share will jump 2% to 3% in 2025. Tariff mania may raise some costs, but the company said it would be “manageable,” putting it a step ahead of arch-rival PepsiCo.
Pfizer jumped 3.28% today after the pharma giant announced that it expects to cut costs by about $7.7 billion by the end of 2027 thanks to advances in AI and automation. Despite lower sales in Q1, the company managed to keep its 2025 revenue guidance of $61 billion to $64 billion intact. While that forecast takes into account the $150 million blow from tariffs, it does not include any future tariffs (which President Trump has threatened to slap on the pharma industry).—LB
Meta Platforms gained 0.85% after the social media giant announced it will launch a standalone AI app to compete with ChatGPT. Expect more details in its earnings call tomorrow.
JetBlue Airways may have pulled guidance, but investors like the airline’s lower-than-expected loss last quarter so pushed shares 2.70% higher.
Speaking of fintech, PayPal climbed 2.14% thanks in no small part to a 20% pop in Venmo revenue.
Honeywell International gained 5.40% thanks to strong earnings and sales for the manufacturing conglomerate.
Deutsche Bank climbed 4.08% after Germany’s largest lender reported a 39% increase in profit last quarter.
Sherwin-Williams may have missed on revenue last quarter, but the paint company beat earnings estimates and kept its forward guidance intact, so shareholders pushed it up 4.80%.
Royal Caribbean eked out a 0.02% despite reporting record bookings and boosting its profit outlook, a rare move these days amid tariff uncertainty.
Leggett & Platt may not be a household name, but it sells household goods—and the bedding company’s solid earnings and strong fiscal guidance sent shares 31.73% higher.
What’s down
General Motors fell 0.64% after the automaker beat on top and bottom line estimates but warned that it will have to pull its forward guidance and suspend stock buybacks.
Spotify dropped 3.04% despite active monthly users rising 10% last quarter. The problem, believe it or not, was lower guidance.
Regeneron lost 6.87% thanks to disappointing sales for its hit eye drug Eylea.
NXP Semiconductors may have beaten analyst estimates last quarter, but management’s lower-than-expected earnings guidance disappointed investors, and pushed shares 6.94% lower.
If you looked at how stocks were doing yesterday morning and then looked away, we’ve got good news.
After a rough start to the day—especially for tech companies, whose earnings are due out soon—stocks mostly turned things around, with the S&P 500 and the Dow ending the day in the green.
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IBM plans to invest $150 billion in the US over five years. That includes $30 billion earmarked for R&D for manufacturing its mainframe and quantum computers in the US. It’s not the only tech company to announce a big commitment to spend in the US since President Trump took office and unveiled steep tariffs on imports from abroad.
Nvidia and Apple have each separately said that they plan to spend $500 billion stateside over the next four years. Companies in other industries, including pharmaceuticals, have also committed to increased US investment.—AR
Much like a springy inflatable structure often resembling a four-sided building and used by children for jumping for sport and fun, stocks staged a much-needed bounce-house back week on hopes that the trade war would de-escalate, with the S&P 500 climbing for four straight days to close 4.6% higher.
Whether the rally continues this week may depend on the Magnificent Seven earnings on tap—each of those Big Tech stocks has fallen at least 6.5% this year, shedding a combined $2.5 trillion in market value, per the Wall Street Journal.
Posted on April 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.
Despite rising Medicare Advantage (MA) utilization, Elevance Health has come out of Q1 2025 unscathed. The company reported adjusted diluted earnings per share of $11.97 and stuck to its prediction of $34.15 to $34.85 adjusted earnings per share for 2025. This contrasts with peer UnitedHealth Group, which lowered its earnings predictions for the year in its call last week following a disappointing quarter. (Elevance released a preview of its earnings in a Form 8-K on April 17, hours after UnitedHealth detailed its surprisingly bad quarter, to reassure investors.)
Tesla gained 9.80% following a White House announcement yesterday that it will loosen US regulations around self-driving cars.
Boston Beer popped 2.26% thanks to strong light beer sales offsetting lower craft beer revenue.
Charter Communications climbed 11.43% after it lost fewer internet customers than last year and beat estimates on both the top and bottom line.
VeriSign rose 8% following strong results for the internet infrastructure company, as well as the announcement of a new dividend.
SoFi Technologies got a 4.63% boost from Citizens JMP analysts, who initiated coverage of the fintech stock with an “outperform” rating and called the company “a compelling long-term investment opportunity.”
What’s down
T-Mobile tumbled 11.22% after the cell carrier added 495,000 new wireless phone subscribers last quarter, below Wall Street’s forecasts.
Gilead Sciences sank 2.81% due to a revenue miss in the first quarter thanks to lower sales of its cancer and Covid treatments.
Avantor plummeted 16.58% after the lab chemicals manufacturer missed estimates, cut its forecast, and announced its CEO is departing.
Saia plunged 30.66% thanks to an enormous first-quarter miss from the shipping company due to customer pullback amid tariff uncertainty.
Investments are soaring: A new SVB report found that women’s health startups saw a whopping 55% increase in VC investments in 2024. Learn about the factors driving this record-breaking funding and the sector’s long-term potential.*
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Posted on April 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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Tesla market value of $780 billion mostly reflects Elon’s future dreams, not car sales. The reality? Only $100-180 billion tied to the actual vehicle business.
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Tesla has a market capitalization as of this writing of $780 billion. It made around $14 billion of profit in 2023 and $7 billion in 2024. A good chunk of profit comes not from selling cars but from regulatory credits. It sold fewer cars in 2024 than in 2023. Unless we see a significant shift change in battery capacity, speed of charging, and improved quality and availability of charging infrastructure, we have reached peak EV penetration (I wrote about this earlier).
However, today Tesla is not trading based on car sales but on future dreams of self-driving robo-taxis, robots, semis, and whatever else Elon dreams up. The car company may be worth $100–180 billion; the rest is what investors are willing to pay for Elon’s dreams.
Quick thoughts on each dream:
Self-driving: I would not trust my life or my kids’ lives to a car company that only uses cameras. They are passive sensors that have limited range and are easily impacted by bad weather. I’ve used Tesla self-driving software – it is great most of the time, except when it’s not – and then it might kill you or others.
Robo-taxis: They may work in geo-fenced areas, but they pose a huge reputational risk to Tesla. One death and this business is done. That’s what happened to Uber’s self-driving business, and why Google’s Waymo has taken a much more conservative route. It uses radar/lidar and launched the service in geo-fenced areas first.
Semis: They were announced in 2017 and were going to hit the road the next year. They are still not out there. I suspect Elon is waiting for a breakthrough in battery technology.
Robots: Exciting, huge market, but this will be a crowded field.
New competition: There are lots of Chinese EVs invading Europe and the rest of the world. BYD looks like a real competitor.
China looked like a great opportunity for Tesla, but may turn into a liability if the trade war intensifies.
Finally, though at times he seems superhuman, Musk is constrained by the number of hours in the day. As of today he is running Tesla, SpaceX, Twitter (x.com), xAI (the maker of Grok – a ChatGPT competitor), The Boring Company, Neuralink, and oh, yes, DOGE. The EV market is getting more, not less, competitive.
Posted on April 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Alphabet has been declared a monopoly for the second time in under a year. Analysts will have plenty of questions about the repercussions of the most recent ruling, but don’t expect a breakup of Google’s many businesses just yet.
And, the best business unit of them all these days is YouTube, which has seen a stunning surge in popularity lately that the search company will likely try to capitalize on, while it continues to tinker with its Gemini AI model. Consensus: $2.02 EPS, $89.25 billion in revenue.
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Intel seems like a bit of an also-ran in the AI race these days, with shares down over 40% in the last 12 months. But to bulls, that just means the stock is cheap, while the company itself has plenty of opportunities for growth ahead, including partnerships with Nvidia and TSMC.
And, don’t forget that Intel’s status as a dark horse lets it slip below the tariff radar—the domestic chip producer dodged the latest round of restrictions that hit Nvidia and AMD. Shareholders will be hoping to hear more good news ahead. Consensus: $0.09 EPS, $12.31 billion in revenue.
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The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
Posted on April 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters and Lawrence Rosenberg
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Cold calling is a term that is typically applied to telesales, but most new business relationships actually begin with a “cold” contact of some kind. Whether through social media, email over the phone or door-to-door, “cold calling” lives up to its name; you are contacting prospects (hopefully decision makers) sans introduction and without warning. In some, if not many cases, you will be presenting to customers who have never heard of you, your firm, or your product/service prior to you getting a hold of them. You will also find yourself coming up against the palace guards (secretaries and personal assistants) whose most important job is to run interference for the boss and thwart any and all attempts that an unfamiliar caller might make to reach them. But, as the sales game will readily teach anyone with the fortitude to last long enough to learn the lesson, the more resistance one faces in the pursuit of a successful outcome, the bigger the payoff will be if one can muster the grit necessary to tough it out.
However difficult the road to riches, cold calling allows for a complete leveling of the playing field. Those that sweep the streets could tomorrow talk with billionaires; a man of little status or worth could enter into a contract with the founder of a blue chip, multinational firm — all with a single, unexpected phone call. The sheer daring of such an approach, its impromptu nature, works for so many reasons, not least of which is that it opens doors. From the intrigue and urgency the suddenness of the call implies, to the instant access a bold overture provides, cold calling is the great equalizer among executives, and a path to achievement open to all, no matter one’s experience, education or connections. Not that there ever were any truly insurmountable barriers to climbing the corporate ladder or accessing its highest rungs that a motivated self-starter could not overcome, but with the advent of the telephone and the brashness of the cold sell perfected, the most entrenched and frustrating of impediments, bureaucracy and fraternalism, ceased to be an obstacle. Yesteryear’s power elite traditionally only did business with friends, acquaintances and family (or perhaps a member of their local country club or lodge), but at the very least, those that connected in business were routinely introduced through a referral. However, the audacity of the unscheduled contact, the inspired notion of a “cold call,” and the realization that it worked, that a person of great esteem or importance was willing to do business with an unusually forward individual, made the glad-handing salesman who relied on his father’s rolodex obsolete.
With ivory towers toppled, etiquette overturned and tradition tossed out, ambitious men ignored propriety and custom and cold canvassed the board of directors and senior executive staff of companies both large and small. The old boy’s network, favoritism, and the “it’s not what you know, but who you know” principle of doing business crumbled in one fell swoop. The ramparts guarded by all manner of gatekeepers and middle men were trampled the moment the CEO became connected by wires to the outside world. Using nothing more than a telephone, a Horatio Alger-type work ethic and a well-rehearsed voice, the business world was invaded by those without patronage, underdogs and unknowns swarmed the gates. The cold call allowed the unfiltered, unapproved spirit of the upstart, unfettered by lackeys and administrators, to enter the inner sanctum of a chieftain and with the power of speech alone, win hearts and minds.
But, can one’s voice really move mountains? Must one not support the message with documentation and material, nurture relationships with lunches and meetings and personally shake hands to set the wheels of industry in motion? Is one unannounced, unsolicited, unscreened call enough?
The human voice is the master manipulator of sound and when paired with the right words it has a potent and intoxicating effect on behavior. Although some people react more favorably to stimulation of the other five senses, sound on its own can evoke them all. Those that study the science of suggestion will note the immense influence of other stimuli, such as that which affects sight and sensation, on how we make sense of our experiences, on how we make decisions, but it is the way in which such sensory bias is communicated (via the written word, and more powerfully, through speech) that truly tells the tale. The combination to unlocking the interests of many a man’s mind are often verbalized in the common yet telling replies to intriguing, thought provoking questions or action demanding requests.
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It is all a matter of deciphering the code, the clue-laden language:
“What you said really touched me.”
“I see the light!”
“You can smell his fear.”
“Let’s give that guy a taste of his own medicine.”
“You are coming across loud and clear.”
The way in which we describe our observations provides the key to how we interpret data, how that data impacts us, and through what primary pathway we process such information. It is our use of language that exposes how we perceive the world around us, how the gears of our minds are moved, and which of the five senses most effectively winds the springs that turn them.
Many times a prospect will request to have a look at your proposition in writing before moving forward, others will react positively based solely on their impression. Some say seeing is believing, but if it soundsexciting and beneficial, they will take action regardless because it just feels right.
All our senses come alive when the brain is stimulated, some more than others depending on the man and the moment, but the terms, phrases and idioms that we use when speaking (their quality, nuance and character) and the way in which they are expressed, have the power to move us in life-changing ways — the spoken word, when used properly, can play us like a piano.
Whether impacted more by sight, olfaction or incitement of the somatosensory system (the way things feel physically), one can induce the imagery and kinesthesia necessary to motivate and influence a prospect from afar with voice alone. Provocative descriptions, the proper use of tone and inflection, and the strategic interweaving of silence (of which sometimes nothing can be more deafening or exert more pressure) can activate or set in motion all manner of action. Practiced speech can lighten the heaviest heart or wrest tears from the coldest stare, it can conjure up a dream state or snap you back to reality. Never underestimate what a skillful performer can do with the right vocabulary and properly trained vocals. Charlton Heston could inspire awe, Orson Welles conjure intrigue, and Luciano Pavarotti demand devotion with nothing more than the weight and timbre of their words.
You too can affect people, positions and outcomes with sonant spirit and verbal substance. Invest in the greatest tool for success a deal maker has, your lexicon, your locution and your delivery.
Posted on April 15, 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 recent study published in the Annals of Internal Medicine found that in 2021, UnitedHealth Group received just under $14 billion in extra Medicare Advantage payments after using a code that made its members appear sicker. It’s another tough break for the plan and provider that has faced allegations of illegally taking additional money from patients and taxpayers, especially after its CEO was fatally shot in early December.
US stocks edged higher on Monday as investors focused on tech’s temporary reprieve from President Trump’s tariffs.
The S&P 500 (^GSPC) trimmed bigger gains to rise a healthy 0.8%. The tech-heavy NASDAQ (^IXIC) also closed off its session high, up 0.6%. The Dow Jones Industrial Average (^DJI) was up around 0.7%, or more than 300 points.
Posted on April 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.
US stocks turned higher on Friday to cap a chaotic week on Wall Street, as investors weighed the latest tariff-related developments in the trade war between the US and China.
The S&P 500 (^GSPC) rose 1.8% after seesawing earlier in the session. The tech-heavy NASDAQ Composite (^IXIC) climbed 2.1%. The Dow Jones Industrial Average (^DJI) advanced 1.5%, about 600 points.
Posted on April 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters and Morning Brew
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Microsoft is celebrating its 50th birthday this week looking like a formerly washed up A-lister who’s suddenly rebounded and getting Oscar noms again.
Ever since Bill Gates and Paul Allen huddled in a garage in 1975 to start a company that’d define the experience of sitting in front of a boxy white PC monitor, Microsoft has had an uneven run. But after years of getting roasted for Internet Explorer, it now seems to be back on top—even briefly beating Apple as the world’s most valuable public company last year.
The tech giant can not only boast bonanza earnings, it also feels like a purveyor of the next big thing again, leading in the AI race through its partnership with OpenAI.
Windows washed
In the 1990s, it felt like Microsoft’s computer geeks were the overlords of tech. Windows powered most PCs, Internet Explorer became the go-to browser, and proficiency in Office tools became standard resume skills. But in the following decade, the company slept on internet tech and smartphones, ceding ground to Apple, Alphabet, and Meta.
It responded by going into midlife crisis mode, aka blowing cash on a series of questionable acquisitions to stay hip. That…didn’t help. By the 2010s, only grandparents could be reached @hotmail.com, Windows phones were a rarity, and no one used Bing as a verb.
When Gates stepped away from running the company in 2000, its new CEO Steve Ballmer grew its revenue threefold by the end of his tenure in 2013. He spearheaded Microsoft’s foray into gaming with the Xbox console and started its blockbuster cloud computing product Azure. But Microsoft’s profit growth slowed dramatically thanks to a massive cash bleed from its shopping spree.
It dropped $6.3 billion on the owner of ad tech platforms aQuantive to compete with Google’s ad business in 2007, only to write it off as a dud five years later.
The company burned at least $8 billion trying to make Windows phones a bigger force by buying Nokia’s cellphone division in 2014.
Microsoft paid $8.5 billion for Skype in 2011, which must’ve made it extra painful to announce that it was sunsetting the video calling service this winter.
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Cash-slinging comeback kid
When it blew out forty candles in 2015, the tech giant was looking past its prime. The stock was trading at around $35 a share, well below its $58 peak in 1999. Its net profit for the year was $12 billion. But investors who held on until now were rewarded with shares going for $374 on its birthday this week after the company reported a net profit of $88 billion in the last financial year.
Much of the revenue now comes from its Azure cloud computing business, which has been boosted by the booming AI industry ravenous for server power.
When Microsoft’s current CEO Satya Nadella stepped into the role in 2014, he doubled down on Azure to make Microsoft into a B2B behemoth selling computing power to tech companies.
It is now the world’s second largest cloud provider after Amazon Web Services, with a 21% market share, according to Synergy Research Group.
Microsoft also bought some businesses that didn’t fail, including LinkedIn—the thought leadership hub with a user base that has soared to 1 billion since the 2016 acquisition. It also owns GitHub, the leading code-sharing platform for software developers. And in its biggest purchase yet, it snagged gaming IP giant Activision Blizzard that owns Call of Duty and World of Warcraft for a whopping $68 billion in 2022, hoping to make itself a dominant caterer to the Xbox joystick-wielding crowd.
It’s an AI company now
The not-quite-acquisition that really got Microsoft its groundbreaker’s glitz back was pouring $13 billion into OpenAI.
Having gotten in on the ground floor of the AI boom, Microsoft is harnessing OpenAI’s models to power its CoPilot AI agent, which it embedded into its Office tools and Teams app. This pits it against other tech giants betting that AI agents automating tasks will be the biggest in-cubicle revolution since Excel.
Posted on April 8, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
ACCOUNTABLE CARE ORGANIZATIONS
Realizing Equity, Access, and Community Health
By Staff Reporters
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Model Overview
The ACO REACH Model provides novel tools and resources for health care providers to work together in an ACO to improve the quality of care for people with Traditional Medicare. REACH ACOs are comprised of different types of providers, including primary and specialty care physicians.
The ACO REACH Model makes important changes to the previous Global and Professional Direct Contracting (GPDC) Model which include:
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Promote Provider Leadership and Governance. The ACO REACH Model includes policies to ensure doctors and other health care providers continue to play a primary role in accountable care. At least 75% control of each ACO’s governing body generally must be held by participating providers or their designated representatives, compared to 25% during the first two Performance Years of the GPDC Model. In addition, the ACO REACH Model goes beyond prior ACO initiatives by requiring at least two beneficiary advocates on the governing board (at least one Medicare beneficiary and at least one consumer advocate), both of whom must hold voting rights.
Protect Beneficiaries and the Model with More Participant Vetting, Monitoring and Greater Transparency. CMS will ask for additional information on applicants’ ownership, leadership, and governing board to gain better visibility into ownership interests and affiliations to ensure participants’ interests align with CMS’s vision. We will employ increased up-front screening of applicants, robust monitoring of participants, and greater transparency into the model’s progress during implementation, even before final evaluation results, and will share more information on the participants and their work to improve care. Last, CMS will also explore stronger protections against inappropriate coding and risk score growth.
In 2015, the Federal Trade Commission (FTC) released a staff report entitled Internet of Things: Privacy & Security in a Connected World, in which it recommend that Internet of Things (IoT) style devices, which of course include medical and clinical devices, need to maintain a good security posture. It’s worth noting that the FDA, FTC, and other government regulators are centering on a few key guidelines. The following recommendations come directly from the FTC report.
Companies should build security into their devices at the outset, rather than as an afterthought. As part of the security by design process, companies should consider:
Conducting a privacy or security risk assessment
Minimizing the data they collect and retain
Testing their security measures before launching their products
Companies should train all employees about good security, and ensure that security issues are addressed at the appropriate level of responsibility within the organization
Companies should retain service providers that are capable of maintaining reasonable security and provide reasonable oversight for these service providers.
When companies identify significant risks within their systems, they should implement a defense-in-depth approach, in which they consider implementing security measures at several levels.
Companies should consider implementing reasonable access control measures to limit the ability of an unauthorized person to access a consumer’s device, data, or even the consumer’s network.
Companies should continue to monitor products throughout the life cycle and, to the extent feasible, patch known vulnerabilities
According to colleague Shahid N. Shah MS, the FTC report and FDA guidelines are remarkably consistent. When thinking of cybersecurity and data privacy, engineers tend to think about authentication, authorization, and encryption. Those are the relatively easy topics. For safety-critical devices, however, things are much more difficult and need to encompass a larger surface of questions, including but not limited to:
Asset Inventory: Is the device discoverable, and can it associate itself with standard IT inventory systems so that revision management, software updates, and monitoring can be automated?
Cyber Insurance: Does the device have enough security documentation to allow it to be insured by standard cyber insurance riders?
Patching: How is the firmware, operating system (OS), or application going to be patched by IT staff within hospitals (or the home for remote devices)?
Internal Threats: Has the device been designed to circumvent insider (hospital staff, network participants, etc.) threats?
External Threats: Has the device been designed to lock down the device from external threats?
Embedded OS Security: Is the device sufficiently hardened at the operating system level, such that no extraneous software components, which increase the attack surface, are present?
Firmware and Hardware Security: Are the firmware and hardware components sourced from reputable suppliers and free of state-sponsored spying?
Application Security: Is the Microsoft Security Development Lifecycle (SDL) or similar software security assurance process integrated into the engineering process?
Network Security: Have all network protocols not in use by the device been turned off so that they are not broadcasting?
Data Privacy: What data segmentation, logging, and auditing is being done to ensure appropriate data privacy?
HIPAA Compliance: Have proper steps been followed to ensure Health Insurance Portability and Accountability Act (HIPAA) compliance?
FISMA Compliance: If you’re selling to the federal government, have proper steps, such as use of Federal Information Processing Standard (FIPS) certified encryption, been followed to ensure Federal Information Security Management Act (FISMA) compliance?
Data Loss Prevention (DLP): Is there monitoring in place to ensure data leakage outside of the device doesn’t occur?
Vulnerabilities: Have common vulnerabilities such as the Open Web Application Security Project (OWASP) Top 10 been reviewed?
Data Sharing: Are proper data sharing agreements in place to allow sharing of data across devices and networks?
Password Management: Are passwords hardcoded into the device or made configurable?
Configuration Protection: Are configuration files properly check-summed and protected against malicious changes?
ASSESSMENT
It is vital to perform a security assessment on a healthcare practice to understand the environment, identify risks and perform risk mitigation. A one-time security assessment with risk mitigation is not sufficient in 2025. This is a continuous process that needs to be performed religiously to maintain a secure and compliant practice.
Your knee hurts, so you pay a visit to your favorite orthopedist. He smiles, maybe even gives you a hug, and then tells you: “I feel your pain. Really, I do. But I don’t treat left knees, only right ones. I find I am so much better with the right ones. Last time I worked on a left knee, I didn’t do so well.”
Though many professionals — doctors as well as lawyers, architects and engineers — get to choose their specializations, they rarely get to choose the problems they solve. Problems choose them. Investors enjoy the unique luxury of choosing problems that let them maximize the use of not just their IQ but also their EQ — emotional intelligence.
Let’s start with IQ. Our intellectual capacity to analyze problems will vary with the problem in front of us. Just as we breezed through some subjects in college and struggled with others, our ability to understand the current and future dynamics of various companies and industries will fluctuate as well. This is why we buy stocks that fall within our sphere of competence. We tend to stick with ones where our IQ is the highest.
Though we usually think about our capacity to analyze problems as being dependable and stable over time, it isn’t. It might be if we were characters from Star Trek, with complete control over our emotions, like Mr. Spock, or who lacked emotions, like Lieutenant Commander Data. This is where our EQ comes in.
I am not a licensed psychologist, but I have huge experience treating a very difficult patient: me. And what I have found is that emotions have two troublesome effects on me. First, they distort probabilities; so even if my intellectual capacity to analyze a problem is not impacted, my brain may be solving a distorted problem. Second, my IQ is not constant, and my ability to process information effectively declines under stress. I either lose the big picture or overlook important details. This dilemma is not unique to me; I’m sure it affects all of us to various degrees.
The higher my EQ with regard to a particular company, the more likely that my IQ will not degrade when things go wrong (or even when they go right). There is a good reason why doctors don’t treat their own children: Their ability to be rational (properly weighing probabilities) may be severely compromised by their emotions.
A friend of mine who is a terrific investor, and who will remain nameless though his name is George, once told me that he never invests in grocery store stocks because he can’t be rational when he holds them. If we spent some Freudian time with him, we’d probably discover that he had a traumatic childhood event at the grocery store (he may have been caught shoplifting a candy bar when he was eight), or he may have had a bad experience with a grocery stock early in his career. The reason for his problem is irrelevant; what is important is that he has realized that his high IQ will be impaired by his low EQ if he owns grocery stocks.
There is no cure for emotions, but we can dramatically minimize the impact they have on us as investors by adjusting our investment process. First and foremost, investors have the incredible advantage of picking domains where they can remain rational.
To be a successful investor, you don’t need Albert Einstein’s IQ (though sometimes I wish I had Spock’s EQ). Warren Buffett undoubtedly has a very high IQ, but even the Oracle of Omaha chooses carefully his battles; for instance, he doesn’t invest in technology stocks.
Investors have the luxury of investing only in stocks for which both their IQ and EQ are maximized, because there are tens of thousands of stocks out there to choose from, and they need just a few dozen.
Meanwhile, I hope when I go see the doctor, he will tell me, “I don’t do left knees,” because the best result will come from a doctor who while treating me will utilize both IQ and EQ.
Posted on April 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.
Microsoft is reportedly pulling back on data center projects around the world as it reexamines its AI plans. Hershey reportedly bought the popcorn brand LesserEvil for $750 million.
US stocks cratered on Friday with the Dow Jones Industrial Average (^DJI) plunging more than 2,200 points after China stoked trade-war fears and Fed Chair Jerome Powell warned of higher inflation and slower growth stemming from tariffs.
The Dow pulled back 5.5% to enter into correction territory. Meanwhile, the S&P 500 (^GSPC) sank nearly 6%, as the broad-based benchmark capped its worst week since 2020. The tech-heavy NASDAQ Composite (^IXIC) dropped 5.8% to close in bear market territory.
Posted on April 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.
Roughly $2.5 trillion was erased from the S&P 500 Index on Thursday amid worries that President Donald Trump’s sweeping new round of tariffs could plunge the economy into a recession. The damage was heaviest in companies whose supply chains are most dependent on overseas manufacturing. Apple Inc., which makes the majority of its US-sold devices in China, fell 9.3%. Lululemon Athletica Inc. and Nike Inc., among companies with manufacturing ties to Vietnam, were both down more than 9%. Target Corp. and Dollar Tree Inc., retailers whose stores are filled with products sourced outside of the US, dropped more than 10%.
The tech-heavy NASDAQ Composite (^IXIC) led the sell-off, plummeting 6%. The S&P 500 (^GSPC) sank nearly 5%, while the Dow Jones Industrial Average (^DJI) tumbled 4%. The Dow’s 1,700-point drop was the fifth-worst in its history.
Suppose that in a new Accountable Care Organization [ACO] contract, a certain medical practice was awarded a new global payment or capitation styled contract that increased revenues by $100,000 for the next fiscal year. The practice had a gross margin of 35% that was not expected to change because of the new business. However, $10,000 was added to medical overhead expenses for another assistant and all Account’s Receivable (AR) are paid at the end of the year, upon completion of the contract.
Cost of Medical Services Provided (COMSP):
The Costs of Medical Services Provided (COMSP) for the ACO business contract represents the amount of money needed to service the patients provided by the contract. Since gross margin is 35% of revenues, the COMSP is 65% or $65,000. Adding the extra overhead results in $75,000 of new spending money (cash flow) needed to treat the patients. Therefore, divide the $75,000 total by the number of days the contract extends (one year) and realize the new contract requires about $ 205.50 per day of free cash flows.
Assumptions
Financial cash flow forecasting from operating activities allows a reasonable projection of future cash needs and enables the doctor to err on the side of fiscal prudence. It is an inexact science, by definition, and entails the following assumptions:
All income tax, salaries and Accounts Payable (AP) are paid at once.
Durable medical equipment inventory and pre-paid advertising remain constant.
Gains/losses on sale of equipment and depreciation expenses remain stable.
Gross margins remain constant.
The office is efficient so major new marginal costs will not be incurred.
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Physician Reactions:
Since many physicians are still not entirely comfortable with global reimbursement, fixed payments, capitation or ACO reimbursement contracts; practices may be loath to turn away short-term business in the ACA era. Physician-executives must then determine other methods to generate the additional cash, which include the following general suggestions:
1. Extend Account’s Payable
Discuss your cash flow difficulties with vendors and emphasize their short-term nature. A doctor and her practice still has considerable cache’ value, especially in local communities, and many vendors are willing to work them to retain their business
2. Reduce Accounts Receivable
According to most cost surveys, about 30% of multi-specialty group’s accounts receivable (ARs) are unpaid at 120 days. In addition, multi-specialty groups are able to collect on only about 69% of charges. The rest was written off as bad debt expenses or as a result of discounted payments from Medicare and other managed care companies. In a study by Wisconsin based Zimmerman and Associates, the percentages of ARs unpaid at more than 90 days is now at an all time high of more than 40%. Therefore, multi-specialty groups should aim to keep the percentage of ARs unpaid for more than 120 days, down to less than 20% of the total practice. The safest place to be for a single specialty physician is probably in the 30-35% range as anything over that is just not affordable.
The slowest paid specialties (ARs greater than 120 days) are: multi-specialty group practices; family practices; cardiology groups; anesthesiology groups; and gastroenterologists, respectively. So work hard to get your money, faster. Factoring, or selling the ARs to a third party for an immediate discounted amount is not usually recommended.
3. Borrow with Short-Term Bridge Loans
Obtain a line of credit from your local bank, credit union or other private sources, if possible in an economically constrained environment. Beware the time value of money, personal loan guarantees, and onerous usury rates. Also, beware that lenders can reduce or eliminate credit lines to a medical practice, often at the most inopportune time.
4. Cut Expenses
While this is often possible, it has to be done without demoralizing the practice’s staff.
5. Reduce Supply Inventories
If prudently possible; remember things like minimal shipping fees, loss of revenue if you run short, etc.
6. Taxes
Do not stop paying withholding taxes in favor of cash flow because it is illegal.
Hyper-Growth Model:
Now, let us again suppose that the practice has attracted nine more similar medical contracts. If we multiple the above example tenfold, the serious nature of potential cash flow problem becomes apparent. In other words, the practice has increased revenues to one million dollars, with the same 35% margin, 65% COMSP and $100,000 increase in operating overhead expenses.
Using identical mathematical calculations, we determine that $750,000 / 365days equals $2,055.00 per day of needed new free cash flows! Hence, indiscriminate growth without careful contract evaluation and cash flow analysis is a prescription for potential financial disaster.
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 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.
Donald Trump has officially dropped a stablecoin. It’s called USD1, and it’s pegged 1:1 with the US dollar, according to a statement from his family company World Liberty Financial Inc, (WLFI) today. The company says the token is fully backed by short-term US government treasuries, USD deposits, and other cash equivalents. Every token equals one dollar, no exceptions. WLFI says it built the whole thing to give people a stablecoin they don’t have to second guess.
US stocks rose for a third day in a row despite souring consumer confidence — and as investors weighed whether President Trump would temper his plans for upcoming tariffs.
The benchmark S&P 500 (^GSPC) rose more than 0.1%, while the Dow Jones Industrial Average (^DJI) ticked just above the flatline. The tech-heavy NASDAQ Composite (^IXIC) rose nearly 0.5%, bolstered by a more than 3% jump from Tesla (TSLA).
Posted on March 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.
US stocks closed near session highs on Monday as investors welcomed reports that the next wave of President Trump’s tariffs will be narrower than expected.
The S&P 500 (^GSPC) rose almost 1.8% on the heels of the broad benchmark snapping a four-week losing streak. The Dow Jones Industrial Average (^DJI) advanced 1.4%, while contracts on the tech-heavy NASDAQ Composite (^IXIC) led the gains, up 2.3%.
Posted on March 24, 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.
Futures attached to the benchmark S&P 500 (ES=F) rose 0.6%, with NASDAQ 100 (NQ=F) futures up 0.7%. Futures tied to the Dow Jones Industrial Average (YM=F) advanced around 0.4%.
Posted on March 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.
The S&P 500 edged up 0.1%. The index finished with a 0.5% gain for the week. It’s still down 4.8% so far this month. The Dow Jones Industrial Average eked out a 0.1% gain, while the NASDAQ composite rose 0.5%.
It appears Medicare coverage for tele-health is here to stay—at least for the next six months. When the House of Representatives and Senate passed a budget on March 11t and 14th, respectively, they not only avoided a government shutdown, but also extended a resolution for Medicare to cover non-behavioral health tele-health appointments until September 30th.
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Posted on March 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.
U.S. stock indexes edged lower Thursday following another reminder that big, unsettling policy changes are underway because of President Donald Trump, along with more signals suggesting the U.S. economy remains solid for now.
The S&P 500 slipped 0.2% after flipping between modest gains and losses through the day. The Dow Jones Industrial Average dipped by 11 points, or less than 0.1 %, and the NASDAQ composite fell 0.3%.
Posted on March 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.
Stat: $1.2 billion. That’s how much San Diego-based Scripps Health plans to spend building a new hospital in San Marcos, California. (Becker’s Hospital Review)
Read: What WHO Director-General Tedros Adhanom Ghebreyesus said about USAID cuts. (Stat)
Pharm fresh: Check out in-depth strategies designed to help increase engagement between pharma reps and primary care clinicians. It’s all right here in Pri-Med’s research. Read the report.
Shares of Charles Schwab Corp. SCHW+1.51% rallied 1.51% to $78.73 Wednesday, on what proved to be an all-around favorable trading session for the stock market, with the S&P 500 IndexSPX+1.08% rising 1.08% to 5,675.29 and the Dow Jones Industrial AverageDJIA+0.92% rising 0.92% to 41,964.63.
Posted on March 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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Today, I’m going to share stories about my best and worst investment decisions. But don’t worry, this isn’t just a brag-and-cringe session about making or losing money. These stories are about the valuable lessons learned, and how these adventures in investing helped shape my current approach.
The Best Investment Decision
In investing, you don’t get extra points for creativity or difficulty. A million dollars earned while you are smiling buys as many potatoes as a million dollars that cost you your marriage and hair.
However, from a personal, creative satisfaction perspective, our investment in Uber was one of our best. That’s not to say that it has been the most successful decision from a financial perspective, at least not yet.
Uber doesn’t fit into the traditional value stock category. Until 2023, the third year of our ownership, it never made money. It was a stock everyone hated. After we bought it, I had clients reach out to me asking if I had been kidnapped and someone else was making these purchases of Uber.
We bought more shares very opportunistically during and after the pandemic. I wrote a long research report on it, which you can read here.
On one hand, Uber’s switchboard is a digital business, but the company also has a physical presence in thousands of cities, which incurs costs (the analog side of the business). Additionally, the availability of cheap money caused the ride-share market to go crazy and act rationally irrational, as competitors jostled in a land grab.
My thesis consisted of several insights:
Unlike traditional-tech, digital-only companies, Uber is a hybrid, both digital and analog. Thus, its cost structure is much higher than that of other companies. This, in part, explains the higher losses.
It has a strong brand; its name has become a verb.
The rideshare market is inevitable and will only continue to grow. Uber is not just in competition with taxis, second cars, or seldomly used cars; it is also in competition with the favors we ask of friends and relatives, such as dropping us off at the mechanic or picking us up from the doctor’s office.
Uber has global scale, which its competitors lack, allowing it to spread R&D across more markets.
As its revenue grows, each incremental dollar comes with a very high margin, which directly drops to the bottom line. Therefore, at some point, its earnings will explode to the upside as fixed costs stop growing, allowing it to scale.
The Uber story is not over; we still own the stock. I don’t want to do a celebratory dance. But this idea came with a lot of creative satisfaction. There is another point of pride here. Despite our very tumultuous ownership of this stock, we remained rational (I have written about that here). We bought more when it became extremely undervalued, and I would be lying if I said that was psychologically easy – it was not, but we followed our research and process.
The Worst Investment Decision
My worst investments that resulted in losses had several things in common: They were low-quality companies; their financials were complex and not transparent (for instance, one-time items were labeled as “one-time” every quarter); and they had questionable management.
However, they were all considered “cheap”… until they were not. Now, I hope you see why I am dogmatic about quality.
However.
When you are wrong on an investment and you lose money, the most you can lose is 100%. I have learned a lot from those. But they were not my worst investments. Those were the ones where I left 300–400% on the table when I sold too soon. Let me detail two examples.
EA – Electronic Arts
We bought EA in the early 2010s. I wrote about it – you can read my investment case for it here. To sum up, games were moving from being sold in stores to being digital downloads, which would lead to higher margins (don’t have to pay for packaging and Best Buy to sell them). The market for games was exploding, as every adult and teenager had a gaming device in their hands – a smartphone. The market for video games was going to be much larger. EA was the largest player in that space, with great franchises.
The following two years of ownership were very painful. EA had a few big game flops, and the market did not care about improving fundamentals. The stock kept declining. We continued to buy more. Every time we bought more shares, the stock fell further. Fast-forward a year or two. The stock doubled from our original purchase, but I was mentally exhausted. I did a celebratory dance and sold the stock. The stock then went up another 4x within a few years after we sold it. It went up for the right reasons – its earnings exploded to the upside, in line with my original thesis.
The sale was a mistake, not because the price went up but because I let frustration over the stock-price decline (volatility) get to me. Investing is a mental game. I learned from this adventure that it is important to zoom out and not obsess over individual stocks in the portfolio. This is why we have a portfolio. It was a very costly but educational mistake. Our ownership of Uber was not a walk in the park, either – just look at the stock price over the last few years. But I had learned my lesson from EA and was able to do the analysis, update our model, and zoom out.
In investing, there is a big difference between intellectual and tactile knowledge. I am going to go PG-13 on you for a second and quote the irascible Charlie Munger: “Learning about investing through a model portfolio is like learning about sex through romantic novels.” A big part of investing is observing yourself as an investor – your thoughts and emotions as you ride the actual rollercoaster of owning a stock.
I also made an important modification to our process.
We always value every company in the portfolio on earnings (free cash flows) at least four years out. Why four years? Three seems too short. There is no magic in this number, other than it being longer than most analyst estimates. We do this for all stocks in the portfolio, and then the total return for each is calculated and annualized. If a company has strong growth potential, it may appear to be expensive based on current earnings; but in reality, it may actually be cheap based on earnings projected four years from now.
On the other side of the spectrum, a company that has no growth or dividends may seem “cheap” based on its current earnings multiple, but this cheapness may quickly dissipate once a total return is calculated using future earnings. Time is on the side of growing businesses and the enemy of the ones that stand still. Therefore, a non-growing or slow-growing business needs a much greater discount (margin of safety) to secure a spot in our portfolio.
I want to stress another point. We sometimes sell a stock and then it goes higher. If we sold it for the right fundamental reasons, this doesn’t bother me. There is very little to learn.
Twilio
I’ll give you another crazy example. We bought Twilio at $25 in 2017 or so. Our thesis was that they had built the largest digital telecommunications network, which gave them a brief competitive advantage. They were also spending 5x more on R&D than competitors to build applications around this network, which would give them long-term advantages.
The stock price went up to $60 in a few months without anything significantly changing, so we sold a third of our position. Then it went up to $90, and we sold some more. To our disbelief, we sold the rest at around $120, a bit before the pandemic.
During the pandemic, Twilio’s price hit $400. I had zero regret about not holding on to the shares. Absolutely none. Twilio’s profitability did not match the stock market’s opinion of its price. Twilio’s stock price was as crazy to me at $250 as it was at $300 or $400. After reviewing our models, we concluded that even $120 was at the extreme end of our optimistic assumptions. Fast-forward to today, where the stock is at $60 or so. We are currently sharpening our pencils, but we have not bought the stock – yet.
Selling EA was a mistake; selling Twilio was not.
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Key takeaways
My “best investment decision” with Uber wasn’t just about financial gains, but the creative satisfaction it brought. It taught me the value of sticking to our research and process, even when it’s psychologically challenging.
The worst investments often share common traits: low-quality companies, complex financials, questionable management, and the illusion of being “cheap.” This reinforces my dogmatic stance on prioritizing quality.
Sometimes, the costliest mistakes aren’t the ones where you lose money, but those where you leave significant gains on the table by selling too soon. My experience with EA taught me this lesson the hard way.
There’s a crucial difference between intellectual and tactile knowledge in investing. Actually owning stocks and experiencing the emotional roller coaster is invaluable for developing as an investor.
Selling a stock that later increases in value isn’t always a mistake if the decision was based on sound fundamental reasons. My experience with Twilio illustrates this point – sometimes it’s right to sell even if the price continues to climb.
NOTE:Please read the following important disclosure here.
In the United States, the difference between a Ph.D and a Sc.D is that the former is awarded to most, if not all, disciplines, while a Sc.D is awarded to science or STEM (science, technology, engineering, mathematics) disciplines.
This means that, in the United States at least, a Ph.D and a Sc.D are equal to one another in terms of telling people about an individual’s mastery of a particular skill, training, and prestige. A Ph.D holder and a Sc.D holder are viewed as peers and equals by most, if not all, American universities.
Meanwhile in Europe, according to Emily Summer, the difference between a Ph.D and a Sc.D is that the former is awarded at the start of an academic career, while the Sc.D is awarded much later, after the individual has built up an impressive body of work.
Posted on March 15, 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.
At least eight agencies are investigating a recent fire at a Bayer executive’s New Jersey home as a possible arson, authorities said. The fire happened around 7:30 a.m. March 4th “at an occupied residence on East Lane in Madison,” the Morris County Prosecutor’s Office told CNN yesterday.
US stocks bounced back sharply on Friday to cap a volatile week on Wall Street as the risk of a government shutdown eased while investors stayed on watch for the next move in an escalating trade war. The S&P 500 (^GSPC) climbed more than 2.1% after the benchmark index sank on Thursday to close in correction territory. The NASDAQ Composite (^IXIC) jumped over 2.6% as tech stocks soared. The Dow Jones Industrial Average (^DJI) moved up more than 600 points, or 1.6%.
Yesterday March 14th was Pi Day! (Yes, the mathematical constant, although we fully support celebrating with actual pie.) Put simply, Pi—aka π—is the ratio of a circle’s circumference to its diameter. It also sneaks its way into medicine. For one, it’s part of Poiseuille’s Law, an equation that helps explain how fluid flows through tubes, including arteries and IV lines. So, whether you’re crunching numbers or crunching on a slice, Pi is definitely worth celebrating
And, today is the Ides of March!
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Posted on March 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DENTAL ADA DEGREES
By Colgate and Staff Reporters
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DDS vs. DMD Degree
DDS and DMD are the acronyms of the degrees dentists earn after finishing dental school. DDS means Doctor of Dental Surgery, and DMD can mean either Doctor of Medicine in Dentistry or Doctor of Dental Medicine. While the names are different, the American Dental Association (ADA) explains that they represent the same education. Some universities may grant dental graduates with a DDS, and others grant a DMD, but both degrees have the same requirements.
According to the ADA, the Baltimore College of Dental Surgery established the first Doctor of Dental Surgery degrees in 1840. When Harvard University started its dental school in 1867, their degrees were called Dentariae Medicinae Doctorate (Doctor of Medicine in Dentistry) because Harvard uses Latin names for their degrees. Even though these degrees are based on the same educational requirements, they still have different names.
Difference Between a DDS and a DMD Degree?
Today, many universities award a DMD degree. Dentists with either a DDS or a DMD are educated to practice general dentistry. All dentists receive a rigorous education. First, dental schools typically require a four-year undergraduate education. Afterward, graduates go to dental school for another four years of classroom training, clinical training, and dental laboratory training.
Dental students spend the first two years of dental school studying biomedical sciences courses like anatomy, biochemistry, pathology, and pharmacology. The last two years are focused on clinical and laboratory training.
After graduating from dental school, dentists must pass a national written examination called the National Board Dental Examination, followed by a regional clinical board examination. Dentists must also pass a jurisprudence examination about state laws before being given a license to practice dentistry in that state.
Post Graduate Education After a DDS or DMD
Most dentists stick with practicing general dentistry. However, some choose to specialize in a particular area of dentistry after earning their degree. Training programs range from two to six years, depending upon the specialty area. There are several dental specialties, including endodontics, orthodontics, periodontics, prosthodontics, oral surgery, and pediatric dentistry. The ADA can help you find a dentist with a specialty that fits you best.
Dentists receive a rigorous education and have to pass several exams to be able to practice. Whether they have a DDS or DMD after their name, you should choose a dentist based on their skills, types of services provided, communication, and professionalism.
Posted on March 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.
Walgreens Boots Alliance says it has agreed to be acquired by private equity firm Sycamore Partners as the struggling retailer looks to turn itself around after years of losing money. Walgreens said Thursday that Sycamore will pay $11.45 per share, giving the deal an equity value just under $10 billion. Shareholders could eventually receive up to an
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.
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.
Posted on March 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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What is Honeypot?
A Honeypot is a network-attached system used as a trap for cyber-attackers to detect and study the tricks and types of attacks used by hackers. It acts as a potential target on the internet and informs the defenders about any unauthorized attempt at the information system.
Honeypots are mostly used by large companies and organizations involved in cybersecurity. It helps cybersecurity researchers to learn about the different types of attacks used by attackers. It is suspected that even cyber criminals use these honeypots to decoy researchers and spread wrong information. The cost of a honeypot is generally high because it requires specialized skills and resources to implement a system such that it appears to provide an organization’s resources while still preventing attacks at the back end and access to any production system.
Advantages of Honeypot
Acts as a rich source of information and helps collect real-time data.
Identifies malicious activity even if encryption is used.
Wastes hackers’ time and resources.
Improves security.
Disadvantages of Honeypot
Being distinguishable from production systems, it can be easily identified by experienced attackers.
Having a narrow field of view, it can only identify direct attacks.
A honeypot once attacked can be used to attack other systems.
Fingerprinting(an attacker can identify the true identity of a honeypot ).
What is Honeynet?
A honeynet is made up of two or more honeypots connected via a network. Having a linked network of honeypots can be beneficial. It allows organizations to trace how an attacker interacts with a single resource or network point while also monitoring how a hacker moves between network points and interacts with numerous points at the same time.
The goal is to induce hackers to believe that they have successfully breached the network. Having more false network destinations makes the arrangement appear more realistic.
In 1972, Nobel Laureate Kenneth J. Arrow, PhD shocked academe’ by identifying health economics as a separate and distinct field. Yet, the seemingly disparate insurance, tax, risk management and financial planning principles that he also studied are just now becoming transparent to some medical professionals and their financial advisors. Despite the fact that a basic, but hardly promoted premise of this new wave financial planning era, is imprecision.
Nevertheless, to informed cognoscenti like Certified Medical Planners™, the principles served as predecessors to the modern physician-focused financial advisory niche sector. In 2004, Arrow was selected as one of eight recipients of the National Medal of Science for his innovative views.
And now, as a long bull market may be over, and if the current “new-normal” prevails – meaning a 4.5% real annualized rate of return on equities and a 1.5% real rate on bonds – wealth accumulation for all may be reduced.
An Imprecise Science
There is a major variable, dominant in any marketplace that pushes an economy in a forward direction. It is called consumerism. This became apparent while waiting in a doctor’s office one recent afternoon.
Scenario:
The front office receptionist, who appeared to be about 21 years old, was breaking for lunch and her replacement, who appeared not much older, came over to assist. Realizing the propensity for a long wait, one was taken by the size of waiting room and the number of patients coming in and out of the office. [Americans consume healthcare and a lot of it]. There was another notable peculiarity. The sample prescription bags being carried out the door were no match for the bags under everyone’s eyes, including the doctor’s. The office staff was probably working overtime, if not two jobs, and the doctor was working harder and faster in a managed care system.
Assessment
Why? So they all could afford to buy and voraciously consume for their children and themselves. Americans indeed work longer hours than any other industrialized nation.
Conclusion
Finally, as women medical professionals entered the workforce in unprecedented numbers, the stock markets reached an all time high in 2025, even as money was spent at a feverish pace as the Federal Reserve pumped out money in inflammatory fashion.
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%.
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™
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 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
FULL ARTICLE WITH TAKE AWAY POINTS
By Vitaliy Katsenelson CFA
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Key Take Away Points
The Consumer Electronics Show revealed that robotaxis are expanding beyond just Waymo, with multiple players entering the market – this fragmentation could actually benefit Uber’s switchboard system and transform sectors like school transportation.
Chinese EV manufacturers have leapfrogged traditional auto manufacturing much like Africa skipped landlines for mobile phones – their fresh designs and cost advantages could seriously challenge Western incumbents if tariffs weren’t a factor.
Autonomous and remote-controlled equipment is set to revolutionize traditional industries like construction, mining, and farming – transforming physically demanding jobs into office work and potentially reshaping immigration policy needs.
The path to cracking the US market has fundamentally changed – companies no longer need traditional retail gatekeepers like Best Buy or Costco, just a product and Amazon advertising budget, as demonstrated by companies like Renpho.
Brand value remains crucial in an era of rapid technology commoditization – your observations of the 15 Oura ring competitors and the GoPro story demonstrate that without strong brand differentiation, even good products can’t command premium pricing in today’s market.
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Full Article
I wrote this from Las Vegas, where my son Jonah and I were at CES (the Consumer Electronics Show).
In investing and life, it’s very easy to get tunnel vision – doing what works and staying in your comfort zone. I wanted to attend CES to shake myself out of this pattern.
It’s hard to describe how massive this event is. It sprawls through five enormous pavilions at the Las Vegas Convention Center and takes up two floors of the Venetian Hotel. It is attended by over one hundred thousand people.
Here are my initial, off-the-cuff, somewhat random thoughts from CES.
Robotaxis There were several robotaxi companies here, in addition to Alphabet’s Waymo. Multiple robotaxis are going to hit the market over the next few years; it won’t be just Waymo. Most will start geofenced (they’ll work in specific areas), just like Waymo did.
This is good news for Uber: The more fragmented the robotaxi market, the more players are in this market, the more valuable is Uber’s switchboard system (which will bring higher utilization to robotaxi operators).
This will also hugely transform public transportation. Think about school buses – that market is primed for disruption since most buses follow the same route every day in a relatively small area.
Chinese EVs Chinese electric cars are awesome. This reminds me of what happened in Africa. Most of Africa skipped phone landlines completely and went straight to wireless phones. Similarly, Chinese automakers weren’t great at making regular gas-powered cars (everyone else had dominated that space), so they just leapfrogged straight to electric cars. And leapfrog they did – they’ll make even Tesla work hard.
I can’t speak for their reliability, but their designs are fresh; and without labor unions mandating how many workers need to screw in a single lightbulb, they’re much cheaper than Western alternatives.
If they hit the US market without tariffs, they would decimate the incumbents – similar to what Japanese carmakers did in the early 80s to the Big Three.
Machines on Autopilot Autonomous and remote-controlled equipment is going to change construction, mining, and farming completely. Imagine excavators digging dirt on a project in the middle of nowhere, operated remotely from air-conditioned urban offices – maybe even by experienced operators brought out of retirement.
Jobs that were physically demanding and that pulled workers away from their families are going to become regular nine-to-five office jobs. This means workers can have normal family lives and work longer – way past when they’d normally have to retire due to the physical demands of the job.
Or picture a colony of Caterpillar trucks working autonomously 24/7 at a mine site. The efficiency and safety gains would be huge. You’ll still need workers, but different workers, and fewer of them.
Think about agriculture. All those jobs that “Americans don’t want to do” will be done by tractors or other farm equipment going through strawberry fields, using AI to spray pesticides only where needed and collecting apples and oranges.
Here’s an economic observation with slight policy overtones: The nature of the job market will change. This is one of those turning points in history where our immigration policy should be forward-thinking, adjusted for the world where AI will be playing a larger role in it (that is inevitable), not just focused on the past and today’s needs.
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Cracking the US Market China has a significant competitive advantage in manufacturing; it has a very robust ecosystem and well-oiled supply chain – nothing new here. Its labor is no longer the cheapest, but Chinese manufacturing is getting more automated.
We talked to one of the chief designers of Renpho, a Hong Kong company that makes digital scales (among other gadgets) and is the number one seller of those scales on Amazon. They outsource all manufacturing to China, and the factory that manufactures their scales is completely automated.
What’s also interesting is that in the past, to break into the US market, you had to have relationships with Best Buy and Costco. They were the gatekeepers and also the quality-control testers. Today, all you need is a product. You have direct access to the US consumer through Amazon – you just have to be willing to spend on Amazon advertising to promote your product.
Brand or Bust It’s incredible how fast technology gets commoditized. There are literally fifteen (!) companies selling Oura-like rings (sleep-tracking biometric devices worn as a ring; I’ve been wearing one for five years).
In technology, you need to keep moving all the time or you’ll be eaten by the competition (true in life in general), but you also need a strong brand. I couldn’t tell the difference between my Oura ring and the fifteen replicas, most of them sold at a fraction of Oura’s price. But I trust Oura, and that’s the power of the brand.
I remember researching GoPro stock after it got bombed out (down 80%). During our research, I found that GoPro was selling their cameras for $300-400, while Chinese-made, no-name replicas were sold on Amazon for $40. These replicas didn’t have GoPro’s brand, but they had tens of thousands of five-star (hard to fake) reviews on Amazon. GoPro may have been exceptional (loved by pros), and these no-name cameras were just okay, but they were 10 times cheaper.
I put GoPro stock into the “too hard” pile and moved on – thank God I did; after declining 80%, the stock fell another 80%.
This brings me back to the value of a brand. GoPro wasn’t worth 10x more to consumers than Chinese no-name alternatives. Can Oura command 10x pricing over its no-name competitors? I don’t know. That’s the beauty of investing – I don’t have to have an actionable opinion on everything. With time I have become very comfortable saying “I don’t know.” Investing is one of the few professions where you don’t have to have an answer for everything. “I don’t know” should be the default answer, unless you do know. Which isn’t that often.
Global Tech Showdown Korean companies are really dominating screen technology. LG and several other Korean companies showed off transparent, glass-like LCD screens at CES. Imagine sitting in your self-driving car, and your windows are both regular see-through glass and LCD screens at the same time. Our lives are slowly becoming what we used to see in sci-fi movies, and these screens are definitely a leap in that direction.
CES is a truly global show, with technology on display that spans every aspect of our future. There were a lot of companies from Asia (especially China). In certain pavilions focused on consumer or business hardware, China completely dominated the exhibits. There were quite a few large American companies and many American startups, mostly focused on software (though all their hardware was manufactured in Asia). America still dominates in software.
A few, mainly Chinese, companies were showcasing their humanoid robots. One robot was slowly but accurately moving and stacking boxes in a defined area. Others were roaming more freely and were good at avoiding objects. At this point, these robots have the IQ of a smart dog, an average cat (now cat lovers will love me), or Siri. I bet in a few years this will have changed.
I was only mildly surprised by how few European companies were at the show. It’s a very broad generalization, but Europe seems to be running on fumes of past glory. Western Europe has become a pro at regulation and mastered the redistribution of wealth (activities that don’t help innovation or economic growth), and not much else. Yes, there are exceptions, but that’s the point – they are exceptions. If Europe doesn’t change course, eventually it will run out of fumes.
The beauty of learning is that you don’t always know everything you’ve learned at the moment of learning. Often, you’re just depositing data points that will crystallize into insights at a much later date. I don’t know if CES will become an every-year tradition or something I do sporadically, but it’s definitely fertile ground for learning.
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™
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™
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%.
Posted on February 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITIONS
By SBA and Staff Reporters
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Acquisition
The acquiring of supplies or services by the federal government with appropriated funds through purchase or lease.
Affiliates
Business concerns, organizations, or individuals that control each other or that are controlled by a third party. Control may include shared management or ownership; common use of facilities, equipment, and employees; or family interest.
Best and Final Offer
For negotiated procurements, a contractor’s final offer following the conclusion of discussions.
Certificate of Competency
A certificate issued by the Small Business Administration (SBA) stating that the holder is “responsible” (in terms of capability, competency, capacity, credit, integrity, perseverance, and tenacity) for the purpose of receiving and performing a specific government contract.
Certified 8(a) Firm
A firm owned and operated by socially and economically disadvantaged individuals and eligible to receive federal contracts under the Small Business Administration’s 8(a) Business Development Program.
Contract
A mutually binding legal relationship obligating the seller to furnish supplies or services (including construction) and the buyer to pay for them.
Contracting
Purchasing, renting, leasing, or otherwise obtaining supplies or services from nonfederal sources. Contracting includes the description of supplies and services required, the selection and solicitation of sources, the preparation and award of contracts, and all phases of contract administration. It does not include grants or cooperative agreements.
Contracting Officer
A person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.
Contractor Team Arrangement
An arrangement in which (a) two or more companies form a partnership or joint venture to act as potential prime contractor; or (b) an agreement by a potential prime contractor with one or more other companies to have them act as its subcontractors under a specified government contract or acquisition program.
Defense Acquisition Regulatory Council (DARC)
A group composed of representatives from each Military department, the Defense Logistics Agency, and the National Aeronautics and Space Administration and that is in charge of the Federal Acquisition Regulation (FAR) on a joint basis with the Civilian Agency Acquisition Council (CAAC).
Defense Contractor
Any person who enters into a contract with the United States for the production of material or for the performance of services for the national defense.
Electronic Data Interchange
Transmission of information between computers using highly standardized electronic versions of common business documents.
Emerging Small Business
A small business concern whose size is no greater than 50 percent of the numerical size standard applicable to the Standard Industrial Classification code assigned to a contracting opportunity.
Equity
An accounting term used to describe the net investment of owners or stockholders in a business. Under the accounting equation, equity also represents the result of assets less liabilities.
Fair and Reasonable Price
A price that is fair to both parties, considering the agreed-upon conditions, promised quality, and timeliness of contract performance. “Fair and reasonable” price is subject to statutory and regulatory limitations.
Federal Acquisition Regulation (FAR)
The body of regulations which is the primary source of authority governing the government procurement process. The FAR, which is published as Chapter 1 of Title 48 of the Code of Federal Regulations, is prepared, issued, and maintained under the joint auspices of the Secretary of Defense, the Administrator of General Services Administration, and the Administrator of the National Aeronautics and Space Administration. Actual responsibility for maintenance and revision of the FAR is vested jointly in the Defense Acquisition Regulatory Council (DARC) and the Civilian Agency Acquisition Council (CAAC).
Full and Open Competition
With respect to a contract action, “full and open” competition means that all responsible sources are permitted to compete.
Intermediary Organization
Organizations that play a fundamental role in encouraging, promoting, and facilitating business-to-business linkages and mentor-protégé partnerships. These can include both nonprofit and for-profit organizations: chambers of commerce; trade associations; local, civic, and community groups; state and local governments; academic institutions; and private corporations.
Joint Venture
In the SBA Mentor-Protégé Program, an agreement between a certified 8(a) firm and a mentor firm to perform a specific federal contract.
Mentor
A business, usually large, or other organization that has created a specialized program to advance strategic relationships with small businesses.
Negotiation
Contracting through the use of either competitive or other-than-competitive proposals and discussions. Any contract awarded without using sealed bidding procedures is a negotiated contract.
Partnering
A mutually beneficial business-to-business relationship based on trust and commitment and that enhances the capabilities of both parties.
Prime Contract
A contract awarded directly by the Federal government.
Protégé
A firm in a developmental stage that aspires to increasing its capabilities through a mutually beneficial business-to-business relationship.
Request for Proposal (RFP)
A document outlining a government agency’s requirements and the criteria for the evaluation of offers.
SCORE
Counselors to America’s Small Business is a 12,400-member volunteer association sponsored by the SBA. SCORE matches volunteer business-management counselors with present prospective small business owners in need of expert advice.
Small Business
A business smaller than a given size as measured by its employment, business receipts, or business assets.
Small Business Development Centers (SBDC)
SBDCs offer a broad spectrum of business information and guidance as well as assistance in preparing loan applications.
Small Business Innovative Research (SBIR) Contract
A type of contract designed to foster technological innovation by small businesses with 500 or fewer employees. The SBIR contract program provides for a three-phased approach to research and development projects: technological feasibility and concept development; the primary research effort; and the conversion of the technology to a commercial application.
Small Disadvantaged Business Concern
A small business concern that is at least 51 percent owned by one or more individuals who are both socially and economically disadvantaged. This can include a publicly owned business that has at least 51 percent of its stock unconditionally owned by one or more socially and economically disadvantaged individuals and whose management and daily business is controlled by one or more such individuals.
Standard Industrial Classification (SIC) Code
A code representing a category within the Standard Industrial Classification System administered by the Statistical Policy Division of the U.S. Office of Management and Budget. The system was established to classify all industries in the US economy. A two-digit code designates each major industry group, which is coupled with a second two-digit code representing subcategories.
Subcontract
A contract between a prime contractor and a subcontractor to furnish supplies or services for the performance of a prime contract or subcontract.
Posted on February 15, 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“
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Although Berkshire-Hathaway sold 203,091 shares on Friday, it still owns 45 percent of DaVita, Inc. The stake, valued at $6.4 billion, has been part of Berkshire’s portfolio since 2011. The sell-off Friday was after the sale was disclosed to Wall Street after markers closed on Thursday. When Wall Street shut at 4pm in New York, DaVita was down 11.1 percent – the stock’s biggest one-day selloff in almost two years for the kidney dialysis provider company.
The S&P 500 barely budged and slipped by less than 0.1%, a day after rallying within 0.1% of its record set last month. The Dow Jones Industrial Average dipped 165 points, or 0.4%, while the NASDAQ composite rose 0.4%.
A century ago, one fifth of the country was involved in agriculture. Due to the transformation of farming technology, only 1% of the country is now involved in farming, while our supermarkets are flooded with cheap food. I could be wrong, but I don’t see the 19% of the country who used to farm wandering around unemployed. They have retrained to do other things.
Innovation disrupts, but it also creates new jobs and improves the standard of living of society. A century ago, you could not have imagined most of the jobs we have today. I’m not just talking about social media celebrities; think about software engineers, data scientists, cybersecurity experts, etc. In fact, most white-collar jobs you see today did not exist 100 years ago. Yes, if you specialized in driving horse-powered carriages, you had to acquire new skills.
AI will displace many jobs, but it will also empower people with new productivity tools. Microsoft Excel replaced jobs that required people to add up rows of numbers with calculators, but it created many more. In the 1960s, corporations had departments filled with typists. A photocopier and then the personal computer put these hardworking folks out of a job, but they retrained to do other things.
If we have a victim mentality, AI will run us over; if we embrace it and adapt it to our lives, it may become our best friend to do the jobs we are doing, while our soon-to-be-unemployed coworkers complain about AI.
AI may have a similar impact on our lives as electricity did. Unless it becomes sentient and just like the Terminator, it turns against us (smarter people than me cannot agree on this, especially on a reasonable time frame, so I withhold my opinion on it), it will likely improve our lives significantly. One industry that immediately comes to mind is healthcare – we need major disruption in that sector.
AI may disrupt and completely reshuffle the power dynamics in some industries. Travel, for example, comes to mind; we may start looking for trips and booking tickets with the help of our AI assistant without going to the travel websites. Some companies will adapt and become winners, while others won’t and will become market-share donors.
As I am typing this, I realize (again, something I do daily now) how important management is. In our analysis, we should pay close attention to how companies are embracing AI. Are they giving it lip service or are they really adopting it and changing the business to take advantage of it?
ChatGPT is a statistical representation of things found on the web, which will increasingly include ITS OWN output (directly and secondhand). You post something picked up from it and it will use it to reinforce its own knowledge. Progressively a self-licking lollipop.
If you want to see ChatGPT creating art, for the fun of it, spend some time on myfavoriteclassical.com, where I post music articles. Every single picture there is created by AI. I love impressionist artists, and thus I love these little AI creations. However, if you zoom in closer, you’ll find violinists playing with toothpicks, pianists with three hands and cellists with multiple arms and legs.
This self-licking lollipop is impressive, but it still has a lot to learn. (By the way, if you have not signed up to receive my classical music-only articles, you have an opportunity to do it here).
Finally, the more we rely on AI and the more content it creates, the less creative it and we become.
Posted on February 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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US stocks lost ground on Friday after the White House said tariffs against Mexico, Canada, and China will take effect on Saturday, reigniting fears of a coming trade war with the nation’s closest trading partners. White House Press Secretary Karoline Leavitt said the president would impose 25% tariffs on goods from Mexico and Canada, as well as a 10% tariff on goods from China.
All three major gauges fell into the red Friday. The S&P 500 (^GSPC) lost 0.5% at the closing bell, while the Dow Jones Industrial Average (^DJI) shed 0.8%. The tech-heavy NASDAQ Composite (^IXIC) gave up 0.3%, reversing earlier gains.
The dramatic tariff news pushed aside more optimistic updates from earlier in the day, which had buoyed stocks. Solid earnings from Apple (AAPL) and an inflation reading that matched expectations lifted market sentiment for much of the day.
Finally, the S&P and the Nasdaq posted losses for the week of 1% and 1.6%, respectively. The Dow, meanwhile, recorded a weekly gain of 0.3%.
I’ve received emails from readers asking my thoughts on DeepSeek. I need to start with two warnings. First, the usual one: I’m a generalist value investor, not a technology specialist (last week I was analyzing a bank and an oil company), so my knowledge of AI models is superficial. Second, and more unusually, we don’t have all the facts yet.
But this story could represent a major step change in both AI and geopolitics. Here’s what we know: DeepSeek—a year-old startup in China that spun out of a hedge fund—has built a fully functioning large language model (LLM) that performs on par with the latest AI models. This part of the story has been verified by the industry: DeepSeek has been tested and compared to other top LLMs. I’ve personally been playing with DeepSeek over the last few days, and the results it spit out were very similar to those produced by ChatGPT and Perplexity—only faster.
This alone is impressive, especially considering that just six months ago, Eric Schmidt (former Google CEO, and certainly no generalist) suggested China was two to three years behind the U.S. in AI. But here’s the truly shocking—and unverified—part: DeepSeek claims they trained their model for only $5.6 million, while U.S. counterparts have reportedly spent hundreds of millions or even billions of dollars. That’s 20 to 200 times less.
The implications, if true, are stunning. Despite the U.S. government’s export controls on AI chips to China, DeepSeek allegedly trained its LLM on older-generation chips, using a small fraction of the computing power and electricity that its Western competitors have. While everyone assumed that AI’s future lay in faster, better chips—where the only real choice is Nvidia or Nvidia—this previously unknown company has achieved near parity with its American counterparts swimming in cash and datacenters full of the latest Nvidia chips. DeepSeek (allegedly) had huge compute constraints and thus had to use different logic, becoming more efficient with subpar hardware to achieve a similar result. In other words, this scrappy startup, in its quest to create a better AI “brain,” used brains where everyone else was focusing on brawn—it literally taught AI how to reason.
Enter the Hot Dog Contest
Americans love (junk) food and sports, so let me explain with a food-sport analogy. Nathan’s Famous International Hot Dog Eating Contest claims 1916 as its origin (though this might be partly legend). By the 1970s, when official records began, winning competitors averaged around 15 hot dogs. That gradually increased to about 25—until Takeru Kobayashi arrived from Japan in 2001 and shattered the paradigm by consuming 50 hot dogs, something widely deemed impossible. His secret wasn’t a prodigious appetite but rather his unique methodology; He separated hot dogs from buns and dunked the buns in water, completely reimagining the approach.
Then a few years later came Joey Chestnut, who built on Kobayashi’s innovation to push the record well beyond 70 hot dogs and up to 83. Once Kobayashi broke the paradigm, the perceived limits vanished, forcing everyone to rethink their methods. Joey Chestnut capitalized on it.
DeepSeek may be the Kobayashi of AI, propelling the whole industry into a “Joey Chestnut” era of innovation. If the claims about using older chips and spending drastically less are accurate, we might see AI companies pivot away from single-mindedly chasing bigger compute capacity and toward improved model design.
I never thought I’d be quoting Stoics to explain future GPU chip demand, but Epictetus said, “Happiness comes not from wanting more, but from wanting what you have.” Two millennia ago, he was certainly not talking about GPUs, but he may as well have been. ChatGPT, Perplexity, and Google’s Gemini will have to rethink their hunger for more compute and see if they can achieve more with wanting (using) what they have.
If they don’t, they’ll be eaten by hundreds of new startups, corporations, and likely governments entering the space. When you start spelling billions with an “M,” you dramatically lower the barriers to entry.
Until DeepSeek, AI was supposed to be in reach for only a few extremely well-funded companies, (the “Magnificent Ones”) armed with the latest Nvidia chips. DeepSeek may have broken that paradigm too.
The Nvidia Conundrum
The impact on Nvidia is unclear. On one hand, DeepSeek’s success could decrease demand for its chips and bring its margins back to earth, as companies realize that a brighter AI future might lie not in simply connecting more Nvidia processors but in making models run more efficiently. DeepSeek may have reduced the urgency to build more data centers and thus cut demand for Nvidia chips.
On the other hand (I’m being a two-armed economist here), lower barriers to entry will lead to more entrants and higher overall demand for GPUs. Also, DeepSeek claims that because its model is more efficient, the cost of inference (running the model) is a fraction of the cost of running ChatGPT and requires a lot less memory—potentially accelerating AI adoption and thus driving more demand for GPUs. So this could be good news for Nvidia, depending on how it shakes out.
My thinking on Nvidia hasn’t materially changed—it’s only a matter of time before Meta, Google, Tesla, Microsoft, and a slew of startups commoditize GPUs and drive down prices.
Likewise, more competition means LLMs themselves are likely to become commoditized—that’s what competition does—and ChatGPT’s valuation could be an obvious casualty.
Geopolitical Shockwaves
The geopolitical consequences are enormous. Export controls may have inadvertently spurred fresh innovation, and they might not be as effective going forward. The U.S. might not have the control of AI that many believed it did, and countries that don’t like us very much will have their own AI.
We’ve long comforted ourselves, after offshoring manufacturing to China, by saying that we’re the cradle of innovation—but AI could tip the scales in a direction that doesn’t favor us. Let me give you an example. In a recent
interview with the Wall Street Journal, OpenAI’s product chief revealed that various versions of ChatGPT were entered into programming competitions anonymously. Out of roughly 28 million programmers worldwide, these early models ranked in the top 2–3%. ChatGPT-o1 (the latest public release) placed among the top 1,000, and ChatGPT-o3 (due out in a few months) is in the top 175. That’s the top 0.000625%! If it were a composer, ChatGPT-o3 would be Mozart.
I’ve heard that a great developer is 10x more valuable than a good one—maybe even 100x more valuable than an average one. I’m aiming to be roughly right here. A 19-year-old in Bangalore or Iowa who discovered programming a few months ago can now code like Mozart using the latest ChatGPT. Imagine every young kid, after a few YouTube videos, coding at this level. The knowledge and experience gap is being flattened fast.
I am quite aware that I am drastically generalizing (I cannot stress this enough), and but the point stands: The journey from learning to code to becoming the “Mozart of programming” has shrunk from decades to months, and the pool of Mozarts has grown exponentially. If I owned software companies, I’d become a bit more nervous—the moat for many of them has been filled with AI.
Adapting, changing your mind, and holding ideas as theses to be validated or invalidated—not as part of your identity—are incredibly important in investing (and in life in general). They become even more crucial in an age of AI, as we find ourselves stepping into a sci-fi reality faster than we ever imagined. DeepSeek may be that catalyst, forcing investors and technologists alike to question long-held assumptions and reevaluate the competitive landscape in real time.
I’d love to hear your thoughts, so please leave your comment and feedback here. Also, if you missed my previous article “Escaping Stock Market Double Hell”, you can read it and leave a comment here.
Posted on January 29, 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
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Bellwether Nvidia (NVDA) finished the day up nearly 9% after it shaved off a record $589 billion from its market cap on Monday.
Aided by Nvidia’s gains, the tech-heavy NASDAQ Composite (^IXIC) surged over 2%, coming off a closing loss of more than 3%. The S&P 500 (^GSPC) rose around 0.9%, while the Dow Jones Industrial Average (^DJI) gained roughly 0.3%.
Posted on January 24, 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.
At the closing bell, the blue-chip Dow Jones Industrial Average was up 0.9% to 44,565.
And a late-day surge carried the NASDAQ Composite into positive territory in the aftermath of Wednesday’s prodigious AI-driven rally, the tech-heavy index rising 0.2% to 20,053.
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