BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Quishing, or QR phishing, is a cybersecurity threat in which attackers use QR codes to redirect victims to malicious websites or prompt them to download harmful content. The goal of this attack is to steal sensitive information, such as passwords, financial data, or personally identifiable information (PII), and use that information for other purposes, such as identity theft, financial fraud, or ransomware.
This type of phishing often bypasses conventional defenses like secure email gateways. Notably, QR codes in emails are perceived by many secure email gateways as meaningless images, making the users vulnerable to specific forms of phishing attacks. QR codes can also be presented to intended victims in a number of other ways.
QR codes, or Quick Response codes, are two-dimensional barcodes that can be scanned easily with a camera or a code reader application. The main component of a QR code is data storage. QR codes have the capability to store significant amounts of information including URLs, product details, or contact information. Scanning technology allows smartphone cameras or code readers to easily and quickly access the website to which the URL points.
In a quishing attack, the attackers create a QR code and link it to a malicious website. Typically, the attacker will embed the QR code in phishing emails, social media, printed flyers, or physical objects, and use social engineering techniques to entice the victims. For example, victims might receive an email urging them to access an encrypted voice message via a QR code for a chance to win a cash prize.
Upon using their phones to scan the QR code, victims are directed to the malicious site. The site may prompt victims to enter private information, such as login information, financial details, or personal information. In the example above, the site may request the user’s name, email, address, date of birth, or account login information.
Once this sensitive information is captured, attackers can exploit it for various malicious purposes, including identity theft, financial fraud, or ransomware.
Posted on June 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.
Meta Platforms popped 3.62% on a report in the Wall Street Journal that the company is going all-in on using AI to create advertisements.
Applied Digital skyrocketed 48.46% after the data center operator announced two 15-year leases with CoreWeave that will bring in $7 billion in new revenue. CoreWeave rose 7.99%.
BioNTech soared 18.05% on news of a multibillion-dollar collaboration with Bristol Myers Squibb to develop cancer treatments. Bristol Myers Squibb rose 1.06%.
Moderna gained 1.84% thanks to the FDA’s approval of its new Covid vaccine, though it’s only for certain patients.
Blueprint Medicines exploded 26.09% after the biopharma company agreed to be acquired by Sanofi for $9.5 billion.
Auto stocks suffered from fears of higher pricing thanks to President Trump’s steel tariff hike. GeneralMotors tumbled 3.87%, Ford fell 3.86%, and Stellantis slid 3.55%.
Sports-betting stocks took a loss after Illinois lawmakers decided to tax the companies $0.25 per wager made on their apps. DraftKings lost 5.99%, and FlutterEntertainment dropped 2.74%.
Advertising stocks sank on Meta Platforms’ announcement of AI advances in its advertisements. Omnicom Group lost 4.02%, and WPP Group fell 2.45%.
Markets: Stocks closed out a winning month Friday with the S&P500 having its best one since 2023. But the markets are still rattled by the trade war, and stocks wavered during the day after President Trump accused China of breaching its recent trade deal with the US. Investors declined to fall into the Gap after the retail chain said tariffs would cost it up to $150 million this fiscal year.
A thought experiment is a mental exercise where you imagine a situation or scenario to explore an idea, test a theory, or examine a problem. It does not involve physical experiments or data. Instead, it uses reasoning, imagination, and logic to draw conclusions or raise important questions.
Sometimes referred to as the Inverted Spectrum Problem or the Knowledge Argument, this thought experiment is meant to stimulate discussions against a purely physical view of the universe, namely the suggestion that the universe, including mental processes, is entirely physical. This thought experiment tries to show that there are indeed non-physical properties — and attainable knowledge — that can only be learned through conscious experience.
Mary is a brilliant scientist who is, for whatever reason, forced to investigate the world from a black and white room via a black and white television monitor. She specializes in the neuro-physiology of vision and acquires, let us suppose, all the physical information there is to obtain about what goes on when we see ripe tomatoes, or the sky, and use terms like ‘red’, ‘blue’, and so on. She discovers, for example, just which wavelength combinations from the sky stimulate the retina, and exactly how this produces via the central nervous system the contraction of the vocal cords and expulsion of air from the lungs that results in the uttering of the sentence ‘The sky is blue’…What will happen when Mary is released from her black and white room or is given a color television monitor? Will she learn anything or not?
Put another way, Mary knows everything there is to know about color except for one crucial thing: She’s never actually experienced color consciously. Her first experience of color was something that she couldn’t possibly have anticipated; there’s a world of difference between academically knowing something versus having actual experience of that thing.
Posted on May 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.
Medicare may soon be able to reimburse physicians for using artificial intelligence-based medical devices, thanks to a bipartisan bill recently introduced to Congress. The bill, called the Health Tech Investment Act, would set up a payment system for devices that use AI or machine learning, which the bill’s cosponsors say would encourage providers to use the technology in clinical settings and help improve diagnoses.
Stock markets were down in trading on Friday after President Donald Trump said he wanted to impose a 50-percent tariff on the European Union and a new 25-percent tariff on iPhone maker Apple.
The S&P 500 was down around 0.8 percent, the NASDAQ Composite down 1.0 percent, and the Dow Jones Industrial Average of 0.6 percent.
When you visit health clinic or hospital for a medical appointment, you’ll be seen by a doctor, healthcare provider and/or medical prescriber. But what do these words really mean?
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Doctors / Physicians
Doctor of Medicine (MD), Doctor of Podiatric Medicine (DPM), Doctor of Osteopathy (DO, or Doctor of Dental Surgery (DDS/DMD). Doctors, also known as physicians, have extensive prescription privileges across various specialties. They can diagnose medical conditions, prescribe medication, and oversee the overall management of patient care. Doctors include general practitioners, specialists such as cardiologists or dermatologists, and surgeons. Their prescription authority encompasses a wide range of medications to address acute and chronic health conditions, ranging from antibiotics to specialized treatments for complex diseases.
A medical provider is a general term that encompasses a wide range of education levels, skill-sets, and specializations. A provider could be a Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Doctor of Medicine (MD), Doctor of Podiatric Medicine (DPM), Dentist (DDSDMD) or Doctor of Osteopathy (DO).
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Medical Drug Prescribers
Generally, psychologists and therapists do not have prescription privileges. They focus on psychotherapy and counseling rather than medication management. However, some jurisdictions may grant limited prescription rights to psychologists who undergo additional training and certification. Like psychologists, therapists typically do not have prescription privileges. They focus on providing counseling and psychotherapy to address mental health issues and emotional concerns.
Psychiatrists are medical doctors (MD/DO) who specialize in the diagnosis and treatment of mental health disorders. They have full prescription privileges and can prescribe a wide range of medications to manage psychiatric conditions.
In most cases, physical therapistsdo not have the authority to prescribe medication. They primarily focus on rehabilitation and physical interventions to improve mobility and function.
Nurse practitioners are advanced practice nurses with the authority to diagnose, treat, and prescribe medication independently in many states and countries. They undergo extensive education and training, which allows them to provide a wide range of healthcare services, including medication management.
Similar to nurse practitioners, psychiatric nurse practitioners have the authority to prescribe medication for mental health conditions. They specialize in psychiatric and mental health care, offering comprehensive treatment that may include medication management.
Chiropractors primarily focus on diagnosing and treating musculoskeletal disorders through manual adjustments and therapies. They do not have surgical or prescription privileges in most jurisdictions.
Optometrists are trained to diagnose and treat vision problems, including prescribing corrective lenses and medications for certain eye conditions such as infections or inflammation.
Registered nursestypically do not have prescription privileges. They work under the direction of physicians and nurse practitioners, assisting with patient care but not prescribing medication themselves.
Dentists have limited prescription privileges related to dental care, such as antibiotics or pain medications for dental procedures. However, they do not have the authority to prescribe general medications outside of their scope of practice.
Nutritionists typically do not have prescription privileges. They specialize in providing dietary advice and counseling to promote health and well-being through nutrition but do not prescribe medication.
Depending on their scope of practice and legal regulations in their jurisdiction, nurse midwives may have limited prescription privileges for certain medications related to prenatal care, childbirth, and postpartum care.
Posted on May 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.
While stocks usually steal headlines, all eyes were on the bond market today. The 10-year bond yield popped back above 4.5% first thing this morning while the 30-year rose above 5% as fears of larger deficits due to the Republican tax and spending bill gave investors pause. A poorly received auction of $16 billion in 20-year bonds this afternoon only pushed yields higher.
Bitcoin climbed to a new all-time high early in the trading session, touching $109,500 at one point today as investors continue to search for alternatives to bonds and the US dollar.
Crude oil climbed to its highest price in a month on reports of flaring tensions between Israel and Iran, then tumbled lower after the US announced surprisingly high oil inventories.
WeRide soared 21.42% on the announcement that the robotaxi will buy back $100 million of its stock.
What’s down
UnitedHealth Group secretly paid nursing homes to transfer fewer people to hospitals so it could cut costs, according to The Guardian. Shares understandably tumbled 5.79%.
Target missed the mark last quarter, with fewer transactions thanks to DEI boycotts leading to lower sales and profits, pushing shares down 5.21%.
Lowe’s sank 1.77% despite sticking to its full-year guidance, noting that sales to professionals will pad its bottom line.
Palo Alto Network may have beaten analysts’ estimates for sales and profits, but the cybersecurity company still fell 6.80% due to thinner margins.
Take-Two Interactive sank 4.52% after the video game maker put $1 billion in common stock on the market.
Fair Isaac caught strays today from a Trump Administration official who was displeased by the credit analytics company’s decision to raise royalty fees.
Carter’s crashed 15.74% on the announcement that the children’s clothing retailer will slash its dividend due to higher costs from tariffs.
Airline stocks tumbled after the FAA limited flights in and out of Newark Airport. UnitedAirlines fell 3.93%, SouthwestAirlines lost 2.35%, and AmericanAirlines sank 3.52%.
Wolfspeed, easily the best-named stock on the market, may go bankrupt. Shares of the semiconductor supplier dropped 59.11%.
Posted on May 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 S&P 500 snapped a 6-day winning streak as the rally following the US & China tariff ceasefire faded and investors looked elsewhere for buying signals.
Federal Reserve speeches abound this week, with several central bankers warning of an economy under duress.
Both gold and bitcoin consolidated their recent gains, offering investors alternatives to suddenly not-so-safe bonds and a sagging US dollar.
Tesla climbed 0.51% after CEO Elon Musk committed to spending the next five years running the EV manufacturer.
Moderna popped 6.06% after the FDA announced new limits on Covid-19 vaccine approvals that were more lenient than expected.
Warby Parker soared 15.57% on news of a partnership with Google to create smart glasses.
Pony AI rose 5.74% after the Chinese auto maker posted impressive earnings and cited high demand for autonomous taxi rides.
Amer Sports surged 19.05% after the athletic equipment maker posted a strong beat-and-raise earnings announcement.
D-Wave Quantum soared 25.93% after the quantum computing company unveiled its newest computing system.
Levi Strauss & Co. rose 1.42% on the news that the jeans company is selling Dockers to Authentic Brands Group for $311 million.
What’s down
Home Depot fell just 0.61% after the home renovation retailer missed earnings estimates, beat revenue forecasts, kept its fiscal guidance intact, and said it won’t raise prices.
Airbnb tumbled 3.27% after Spain ordered the company to take down over 65,000 listings.
VikingHoldings sank 4.99% despite earnings and sales beating estimates, but investors didn’t like hearing that the the cruise line operator transported fewer passengers last quarter than expected.
AES lost 4.05% after the solar stock was downgraded by Jefferies analysts, who are worried about lower demand for renewable energy.
Posted on May 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.
Nvidia climbed 3.97% on CEO Jensen Huang’s announcement of a partnership with Saudi Arabia-backed Humain to build a 500 megawatt data center.
Advanced Micro Devices popped 4.18% after it, too, revealed it’s helping Humain out. The chipmaker’s board also authorized a $6 billion stock buyback program.
Super Micro Computer continued to rally, soaring another 15.69% on the back of Raymond James analysts’ initiating their coverage with an “outperform” rating.
Boeing climbed 0.59% thanks to a $96 billion deal with Qatar Airlines to buy up to 210 aircraft.
Exelixis soared 19.70% after the oncology company reported a shockingly strong beat-and-raise quarter.
Septerna exploded 28.97% on the news that Novo Nordisk will license its oral obesity pill candidate for $2.2 billion.
What’s down
Airline stockswere down across the board after the FAA met with executives to discuss cutting flights in and out of Newark Airport. Delta Air Lines lost 4.32%, and United Airlines sank 3.51%.
American Eagle Outfitters tumbled 5.93% after the retailer cut its fiscal guidance, announced it’s writing down $75 million in merchandise, and forecast a decline in next quarter’s sales.
Grail plummeted 23.48% after the biotech’s revenue last quarter failed to meet Wall Street’s expectations.
Aurora Innovation fell 7.58% thanks to an announcement from Uber that it’s offering $1 billion in convertible notes that can be exchanged for Aurora shares.
JD.com lost 4.24% after the Chinese online retailer beat earnings expectations yesterday but still saw its price target cut by Morgan Stanley analysts.
Posted on May 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
During the 2024–25 Annual Enrollment Period, Medicare Advantage drew in only 1.3 million new members, compared to 2+ million in each of the five years prior, according to a March 25 report by consulting firm HealthScape Advisors. Traditional fee-for-service Medicare grew by about 200,000 after years of losing hundreds of thousands of members, according to HealthScape. During the 2023–24 AEP, it lost about 800,000.
Semiconductor stocks that looked like some of the biggest losers of the trade war just last week soared on today’s China/US deal. Nvidia popped 5.44%, TSMC rose 5.93%, AMD climbed 5.13%, Broadcom rose 6.43%, and Qualcomm gained 4.78%.
Magnificent Seven stocks also shot higher, particularly Apple (6.31%) and Amazon (8.07%), two companies that were bearing the brunt of higher tariffs.
Tesla jumped 6.75% on the tariff deal news, given a massive production plant that was responsible for 22% of Tesla’s total revenue last year is located in China.
US-listed Chinese stocks popped, for obvious reasons: JD.com gained 6.47%, Alibaba rose 5.82%, and Baidu climbed 5.08%.
Healthcare company Kindly MD soared 251.03% today after merging with Nakamoto, a bitcoin investment company founded by Trump’s crypto advisor David Bailey.
NRG Energy popped 26.21% after it agreed to acquire a slew of natural gas facilities from LS Power Equity Advisors.
Next Technology Holding soared 38.56% after the software company added 5,000 bitcoin to its portfolio and said it wants to add even more.
What’s down
EchoStar tumbled 16.58% today after the Wall Street Journal reported that the Federal Communications Commission was opening an investigation into the firm’s 5G network.
A slew of metal mining stocks fell today as gold declined on the tariff deal: AngloGold Ashanti fell 10.31%, Wheaton Precious Metals dropped 7.92%, NewmontCorporation lost 5.93%, and Gold Fields Limited sank 10.47%.
Posted on May 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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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.
Posted on May 10, 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 is reportedly developing a “super-sensing” mode for its AI glasses that could identify people by name.
De Beers, the South African-British diamond giant, is closing its lab-grown diamond business, the company announced, as the value of human-made gems declines.
Coinbase acquired Deribit, a popular trading platform for bitcoin and ether options, for $2.9 billion.
FEMA acting head Cameron Hamilton was fired yesterday, Politico reported, amid reports that President Trump could look to shrink the department or eliminate it entirely.
Match Group, which owns Hinge and Tinder, cut 13% of its workforce as it seeks a turnaround following several executive departures and pressure from activist investors.
Microchip Technology climbed 12.60% on a solid beat-and-raise quarter for the semiconductor stock.
Pinterest gained 4.84% thanks to higher-than-expected revenue last quarter and projected strong revenue growth in the current quarter.
Insulet popped 20.88% after the insulin device manufacturer crushed Wall Street’s estimates on the top and bottom lines and raised its fiscal forecast.
Trade Desk soared 18.60% thanks to an impressive first quarter for the digital marketing company, including EPS of $0.33 compared to forecasts of $0.25.
DraftKings rose 2.49% thanks to a smaller-than-expected loss last quarter due in part to fewer March Madness upsets than usual.
Cloudflare popped 6.32% on strong earnings after the cloud services provider inked its biggest contract ever last quarter.
Monster Beverage missed first-quarter revenue estimates, but the energy drink giant still managed to climb 1.43%.
What’s down
United Airlines lost 2.69% on the news that Newark Airport experienced its second major outage in two weeks.
Coinbase stumbled 3.48% lower on a surprise revenue miss last quarter, thanks to a 17% decline in consumer trading volume.
Expedia beat profit estimates, but lower revenue thanks to a travel spending slowdown still sank the stock 7.30%.
Sweetgreen was crushed by 16.25% due to full-year fiscal guidance that came in way worse than Wall Street anticipated.
Affirm may have done well in the third quarter, but the Buy Now, Pay Later company fell 14.47% thanks to lower revenue forecasts this quarter.
UnitedHealthcare Group was sued by shareholders claiming the company didn’t properly adjust its earnings outlook following the death of CEO Brian Thompson.
Posted on May 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Ford managed to rise 2.45% despite the automaker suspending its 2025 fiscal guidance, citing “industrywide supply chain disruption impacting production.”
WeRide skyrocketed 31.68% on the news that it’s expanding its partnership with Uber to include rolling out robotaxis in 15 new cities. Pony AI soared 47.63% thanks to its bigger role helping Uber grow throughout the Middle East.
Hims & Hers Health gained 18.12% after the telehealth stock beat analyst forecasts last quarter,even though it provided lower-than-expected revenue guidance this quarter.
Celsius Holdings missed on both top and bottom line expectations, but shares of the energy drink maker still managed to bubble 4.81% higher.
Mattel rose 2.78% even though the toy company paused its fiscal guidance and warned it will raise prices in the US.
Upwork, everyone’s favorite side-gig platform, soared 18.02% as Americans brace for economic upheaval by finding second jobs.
Constellation Energy may have missed Wall Street forecasts last quarter, but shareholders pushed the stock 10.29% higher on upbeat fiscal guidance.
SolarEdge Technologies climbed 11.22% on a smaller-than-expected loss last quarter and projections that tariffs won’t be as bad as feared.
Neurocrine Biosciences popped 8.36% thanks to strong revenue growth due to high sales of its movement disorder treatment Ingrezza.
What’s down
Tesla fell 1.75% on the latest data showing its sales plummeted in Europe last month, including a 46% decline in Germany.
Pharma stocks took a beating after the FDA announced that industry critic Dr. Vinay Prasad will be named its top vaccine regulator. Moderna lost 12.25%, Novavax fell 3.19%, Merck sank 4.59%, and Pfizer fell 4.15%.
Clorox got taken to the cleaners, losing 2.41% after missing Wall Street’s profit forecasts.
Vertex Pharmaceuticals fell 10.03% thanks to big misses across the board last quarter due to higher costs.
Lattice Semiconductor lost 9.28% after management warned that tariffs will have indirect consequences on its business.
US gross domestic product (GDP) contracted 0.3% in Q1, the Commerce Department reported yesterday, missing economists’ expectations of a 0.4% increase.
That drop can likely be attributed to a massive spike in imports (roughly a 41% increase from the previous quarter) from companies stocking up on goods and materials before President Trump’s tariffs took effect. The Commerce Department counts imports as a negative in GDP calculations as they represent spending on foreign goods.
Posted on May 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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The technology at the core of the mania is different every time. What doesn’t change over time is human emotion – the fear of missing out and then the fear of loss.
AI has a feel of “this time is different.” Optimism rarely erupts about the same technology twice; this is why history doesn’t repeat but rhymes. The technology at the core of the mania is different every time. What doesn’t change over time is human emotion – the fear of missing out and then the fear of loss, in that order.
Humans are an optimistic bunch. We need it; it’s essential to our survival and progress; but eventually, we take our optimism too far. The graveyard of financial ruins is full of these stories.
I have beat the dotcoms and Nifty Fifties to death, so let’s go to back another century. My friend the brilliant Edward Chancellor wrote about the railroad boom and bust in England in the 1800s. Here he is, edited for brevity:
The first railway to use steam locomotives opened in 1825 and was designed to carry coal, not passengers. Railway promoters simply did not appreciate the potential demand for high-speed travel. The successful launch of the Liverpool and Manchester Railway in 1830, however, demonstrated the commercial viability of passenger travel. By the early 1840s, Britain’s railway network stretched to more than 2,000 miles. Railway companies were delivering acceptable, if not spectacular, returns for investors.
Then railway fever suddenly gripped the nation. Enthusiasts touted rail transport not just for its economic benefits, but for its benign effects on human civilization. One journal envisaged a day when the “whole world will have become one great family speaking one language, governed in unity by like laws, and adoring one God.” In the two years after 1843, the index of rail stocks doubled.
Investment peaked at around 7% of Britain’s national income. Railway enthusiasts predicted that rail would soon replace all the country’s roads and that “horse and foot transit shall be nearly extinct.”
In 1845, Britain’s railways carried nearly 34 million passengers. If the 8,000 miles of newly authorized railways were to deliver their expected 10% return, then the industry’s total revenue and passenger traffic would have to climb five fold or more – all within the space of just five years. “This should have alarmed observers by itself … But they were deluded by the collective psychology of the Mania”, writes Odlyzko.
In 1847 a severe financial crisis broke out, induced in part by the diversion of large amounts of capital into unprofitable railway schemes. It turned out that the revenue projections provided by so-called “traffic takers” were wildly overoptimistic. Railway engineers underestimated costs. The vogue for constructing direct lines between large urban centers proved mistaken, as most traffic turned out to be local. As a result, Britain’s rail network was plagued with overcapacity. By the end of the decade, the index of railway stocks was down 65% from its 1845 peak.
The railroad bubble in England is just one example; there are hundreds of similar stories across market history. They all share this theme:
A new technology appears on the horizon. In the early stages, investment is rational, but then at some point excitement, imagination, and optimism take over, leading to overinvestment (usually creating a financial bubble). Investors make a lot of money until most lose it all. When the dust settles, only a few companies survive.
This AI boom reminds me of the telecom sector in the 1990s. The internet was going to change the world, and it did, but first we had tremendous overcapacity in global fiber and telecom equipment.
One could say that telecommunications companies overestimated demand for broadband and underestimated changes in technology, and that would be true. But there was a more nuanced dynamic at play, what economists call the fallacy of composition.
What’s true for one participant isn’t necessarily true for the group.
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%.
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