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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital and recruited BOD  member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

    Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.

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The ME-P is your source for the best online-exclusive content in the financial advisory marketing, and financial planning e-prospecting space, for all healthcare professionals [physicians, podiatrists, osteopaths, dentists, chiropractors, nurses, medical CXOs, etc].

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To submit a personal or product presentation video [pod-cast], sponsor a video [pod-cast], or inquire about specific advertising on the ME-P, please contact Ann Miller RN MHA at: 770.448.0769 or MarcinkoAdvisors@msn.com

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In this encore podcast, Somnath Basu PhD MBA examines how the recent economic turmoil has changed financial planning clients’ attitudes and expectations.

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Dr. Basu is a popular ME-P contributor, commentator and “thought-leader”.

Basu Video Link: http://www.youtube.com/watch?v=jzAkB8h5v3Q

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Meet David K. Luke MIM CMP™ [An ME-P Thought-Leader]

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A Physician Focused Financial Advisior and Certified Medical Planner™

Financial Management Experience

https://www.medicuswealthplanning.com/team/david-k-luke

David K. Luke focuses on helping physicians, medical professionals, and successful retirees with financial planning, investment and risk management.

In the past 24 years of industry experience, David has held licenses including general securities registered representative, registered investment advisor, Branch management supervision, and Life, Accident, and Health Producers.

David, a fee-only advisor, is able to help his clients to achieve peace of mind and greater assurance with their financial goals by giving advice and providing investment management that is in their best interest, untainted by commissions or sales objectives. Likewise, in a true fiduciary capacity, he is able to help investors determine the reliability and suitability of products and services that they have been sold by other advisors.

David began his career managing money in 1986 in the General Motors of Canada Banking and Investments department where he was engaged in cash management, foreign currency hedging, and the debt issuance of a $100 million Eurobond and a $300 million Note Issuance facility. In 1988 as Supervisor of Borrowings for GMAC Canada David was responsible for the daily average issuance of $125 million in short-term Commercial Paper. David worked as a stock broker and portfolio manager for 2 major national brokerage firms (A.G. Edwards and Wachovia Securities) from 1989 to 2008.

Additionally, at Wachovia Securities David was among an elite group of financial advisors approved as a PIM (Private Investment Management) Portfolio Manager. Prior to joining Net Worth Advisory Group in 2010, David managed his own independent firm, Luke Wealth Strategies, working as a registered representative and investment advisor.

Education and Designations

  • President 2009/2010, Financial Planning Association (FPA) – Utah Chapter Affiliate
  • National Association of Personal Financial Advisors (NAPFA)
  • Member, Medical Group Management Association Master of International Management (Finance concentration)
  • American Graduate School of International Management Bachelor of Arts, Brigham Young University
  • Certified Medical Planner™ Professiobnal Designation from iMBA, Inc www.CertifiedMedicalPlanner.org

http://www.CertifiedMedicalPlanner.org

Assessment

David is our newest ME-P “thought-leader”. We look foward to his insider comments and posts. So, please welcome him and give his site a click: http://networthadvice.com/our-team/david-k-luke/

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Why 75 Years of American Finance Should Matter to Physician Investors

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

By Dr. David Edward Marcinko FACFAS MBA CPHQ CMP™

http://www.CertifiedMedicalPlanner.org

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

About Kenneth J. Arrow, PhD

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

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

Healthcare Economics Today

Today – as 2019 nears – savvy medical professionals, management consultants and financial advisors are realizing that the healthcare industrial complex is in flux; and this dynamic may be reflected in the overall economy.

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

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

I’m Not a Cassandra

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

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

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

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

What audience?

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

How do I know all this?

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

Evidence from the American Financial Scene, circa 1861-1935

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

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

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

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

Assessment

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

Conclusion      

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

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

Is Hostetler correct, or not; and why?

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

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

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Dr. Marcinko Interviewed on the Physician Credit Crunch

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

By Michael Gibbons

Editor: ADVANCE Newsmagazines

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

Dermatologists and Plastic Surgeons

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

Start Small

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

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

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

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

Patience, Prudence and Passiondem2

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

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

Exit Strategy

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

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

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

Expanding a Practice

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

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

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

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

Assessment

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

Link: Dr. Marcinko Interview

Link: https://healthcarefinancials.files.wordpress.com/2009/08/dr-marcinko-interview.pdf

Conclusion

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

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Sponsors Welcomed

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Happy Birthday Professor Hope Rachel Hetico 2018

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Congratulating a Medical Executive-Post Human Dynamo

  • By Dr. David Edward Marcinko CMP® MBA MBBS
  • By Ann Miller RN MHA
  • By Edward, Teresa and Mackenzie [ME-P staff]

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During this busy post-holidays week, we’d like to acknowledge the birthday of one of our own; Hope Rachel Hetico.

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Despite again being in Chicago on a major corporate executive consulting assignment, Hope is a human dynamo for our holding parent company, the www.MedicalBusinessAdvisors.com and this expanding ME-P publication.

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Professor Hope Hetico

***

In addition to serving as ME-P Managing Editor, she teaches online for our www.CertifiedMedicalPlanner.org program and completed her Co-Editorial duties for our just released 800 page  textbook, Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners®].

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

She also completed editorial work on our 750 page companion text book Comprehensive Financial Planning for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners®].

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

Hope accomplished all this while still leading on-ground classes and B-School health administration teaching assignments using the curriculum she helped outline in our magnum opus www.BusinessofMedicalPractice.com.

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Now, don’t try to guess Hope’s age – you’d be decades off. Suffice it to say – she wears it well. Rather, follow our lead and feel free to give her a warm birthday “shout-out” and great big Mazel-Tov’.

Happy Birthday, Hope!

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

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

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INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Assessment

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Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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About “Comments” on the Medical Executive-Post

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One of Just Many Ways to Interact with Us

By Ann Miller RN MHA

[Executive-Director]

If you are not reading our subscriber “comments”, you are not getting all you can from each Medical Executive-Post. And, if you are not reading the links in each post, you are not getting all you can from the ME-P.

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Then, purchase our textbooks, white-papers, handbooks, dictionaries and CDs for deeper integrated and peer-reviewed industry specificity.

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And, we are now scheduling private consultations, events and corporate engagements, too. Online and on-ground seminars and private appointments are also available! But for now, read and learn from the comments  tab. It’s fast, free and secure!

Conclusion

So, there are several ways to interact with the ME-P, and more are scheduled in the future.

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

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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About the Certified Medical Planner™ Program

Certified Medical Planner

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The Virtual Certified Medical Planner™ Program, from iMBA Inc.

Our flagship 500 hour Certified Medical Planner™ professional designation program is designed for fiduciary focused FAs, CFPs®, CPAs, RIAs and other financial services professionals and/or doctors, nurses, health entity CXOs, managers and administrators [medical management consultants] and those in career transition looking to enhance their theoretical knowledge and practical experience in the integrated and expanding fields of medical practice management and personal financial planning.

In all our courses, we cover the full spectrum for any given topic.  Best of all, we utilize real-life case studies from the marketplace, either as a financial advisor or medical management consultant, so students can actively participate in a mock “working financial advisory group” or “medical managerial team”.

And, our unique CMP™ teaching methodology uses “live” dedicated instructors to help [adult-learners] students understand how to fully integrate quantitative and qualitative analysis when advising clients.

We offer 24/7/365 classes designed for working professionals with a heavy workload or travel schedule. In addition, our courses can be taken without ever having to leave your desk, home, office, practice, or even your hotel room.

Our training program is internet based so most of our students take the course virtually. Nevertheless, while our service delivery model is virtual – the educational benefits and notoriety you receive are REAL!

More info:

Ann Miller RN MHA

[Executive-Director]

www.CertifiedMedicalPlanner.org

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A Simple Formula For Financial Sobriety

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On Changing Financial Behaviors

By Rick Kahler MS CFP® ChFC CCIM www.KahlerFinancial.com

From time to time I offer financial courses through Community Education of the Black Hills. Classes on the fundamentals of making good investments and how to do your own financial planning usually fill quickly.

But, a class on “financial sobriety”—how to change your psychological behaviors around money and begin making wiser money decisions—had only one person sign up. Based on my 30 years of financial advising, this wasn’t a big surprise.

The Research

Research tells us 70% of US citizens have no savings and live month to month or are insolvent. Only 9% have saved over $100,000 and just 3% over $500,000. The stats for medical professionals are not so transparent.

Why is this? The simple answer is Americans have a significant resistance to saving, including some doctors, according to ME-P Editor-in-Chief, Dr. David Edward Marcinko FACFAS MBA CMP® www.CertifiedMedicalPlanner.org

Mathematically, the solution to this is very simple. Out of every dollar earned, do this: First, pay taxes. Second, save and invest 20% or more. Third, live on the rest. This formula has a high probability of successfully creating financial independence.

So, why are fewer than one in 10 Americans able to follow this simple formula? The answer to that isn’t so simple.

Psychological Responses

The first response to these options is often, “I can’t.” Non-savers tell themselves there is nowhere to cut. When put in context of maintaining their current lifestyle, this is true—and therein lies the problem. When you’re living month to month, becoming a saver inherently means either reducing your lifestyle or increasing your income.

Unfortunately, too many people vaguely intend to start saving when their income goes up. This is backwards. Focusing instead on reducing your lifestyle is what creates the habit of saving.

  • For some people, downsizing a lifestyle can mean switching kids from private to public schools or selling expensive cars and homes.
  • For others, downsizing can mean getting rid of cable TV, buying generic brands, and shopping at garage sales instead of Walmart. Most budgets have room for at least a few small cuts. We just can’t see the options, because our brains tell us that reducing our lifestyle will be a fate worse than death.

It may seem that a lifestyle reduction would be a lot easier for high income earner. Yet I’ve seen those earning $750,000 have as much trouble saving $10,000 a year as those earning $50,000. The self-talk and reasons why it’s impossible to cut spending are exactly the same.

Not about Money

It’s not about the money. It’s never about the money. It’s not that most non-savers don’t know the solution to saving more; it’s that they don’t like the solution. We cannot change what we refuse to confront.

It takes a lot of courage to admit you have to change and then take action to actually put a plan into motion. It can feel overwhelming, embarrassing, and fearful. It’s hard saying goodbye to the old lifestyle and the trappings we come to enjoy.

Adaptable Humans

Fortunately, the difficult times are temporary. Humans are very adaptable. Before long you will settle into the new “normal.” You will discover you can be just as happy with your new lifestyle as you were in the old. The anxiety of losing that lifestyle will be replaced with the satisfaction of watching your savings and investments grow, knowing you will someday be able to support yourself without working.

Assessment

Eventually, you will experience much less anxiety than you did when you were living in denial. Knowing you have enough savings to see you through a job loss or other financial calamity is a real anxiety buster.

You may even choose not to increase your lifestyle as your income increases. You’ll be too busy enjoying the financial serenity, satisfaction, and joy that comes with living on less than you earn and building financial independence.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Vital iMBA Inc Links for Savvy Doctors and their Financial Advisors

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An Educational Resource Supporting Doctors and their Consulting Advisors 

Healthcare OrganizationsMedical Business AdvisorsCertified Medical PlannerHDS

We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants. We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you.

In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”

Join the ME-P Nation today … and tell us what you think!

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We are sponsored by the Institute of Medical Business Advisors, Inc

www.MedicalBusinessAdvisors.com

INSTITUTE OF MEDICAL BUSINESS ADVISORS, INC.
Suite #5901 Wilbanks Drive
Norcross, Georgia, 30092-1141 USA
Phone: 770.448.0769

ADMINISTRATORS: http://www.springerpub.com/Search/marcinko
PHYSICIANS:www.MedicalBusinessAdvisors.com
PRACTICE: www.BusinessofMedicalPractice.com
PODIATRISTS: www.PodiatryPrep.com
HOSPITALS:http://www.crcpress.com/product/isbn/9781439879900
ADVISORS:www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

Assessment

Link: Letterhead.iMBA_Inc.

Link: Letterhead CMP

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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Promoting the ME-P Holistic Physician Lifestyle

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Enter the Certified Medical Planners™

By Ann Miller RN MHA

[Executive-Director]

Life planning and behavioral finance, as proposed by physicians and financial advisors, and as integrated by the Institute of Medical Business Advisors (iMBA), emanates from a holistic union of personal financial planning and medical practice management solely for the healthcare space.

Source: https://www.mapsforthat.com/map.php?m=587

The CMP™ Difference

Unlike pure life planning, pure financial planning, or pure management theory, it is both a quantitative and qualitative “hard and soft” science. It has an ambitious economic, psychological and managerial niche value proposition never before proposed and codified, while still representing an evolving philosophy. Its’ zealous practitioners are called Certified Medical Planners (CMPs).

Assessment

Health 2.0 focused physician baby boomers & modern Gen-X financial advisors can help transition you successfully through medical practice and life changing financial events by exchanging knowledge, experiences and inspiration with industry professionals and peers in the casual and friendly atmosphere of the ME-P. Join us today.

More: https://medicalexecutivepost.com/2009/10/20/understanding-behavioral-finance/

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 

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Taxes and the SCOTUS ACA Decision

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My Synopsis for Physician Investors

By Dr. David Edward Marcinko FACFAS MBA CMP™

www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

I was at Emory University this past weekend for an unrelated colloquium. But all the chatter, of course, was about SCOTUS, taxes and the just announced ACA decision.

Most doctors I know – just don’t like paying needless taxes. So, what’s the buzz for physicians and other medical professional investors, and their financial advisors [FAs]?

The Synopsis

The taxes to pay for the Affordable Care Act include a new tax on medical devices that will increase costs to individuals and healthcare providers.

There also is a new 3.8% Medicare tax. It applies in 2013 to income and capital gains.

If the expected post-election tax bill extends the current 15% capital gain rate, then the capital gains tax rate will be 18.8% in 2013. However, if the 15% federal capital gains tax rate is increased to 20%, then the new rate in January of 2013 will be 23.8%.

In addition to dividend seeking investors, the increase in capital gains rate may also influence charitable gifts of appreciated property in 2013.

Assessment

Please weigh-in all you FAs and healthcare focused CPAs. What is a physician investor supposed to do, now?

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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A Survey to Shape the Definition of Physician-Focused Financial Planning

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Send us Your Thoughts

By Dr. David Edward Marcinko MBA CMP®

[Chairman, Founder and CEO]

www.CertifiedMedicalPlanner.org

The Institute of Medical Business Advisors, Inc is re-defining the role of “physician focused financial planning” and how the concept fits within the financial services industry.

Crowd-Sourcing Insights and Opinions

But, we can’t do it without your help. As a medical provider or seasoned financial professional, our readers can provide valuable input to determine exactly what constitutes a physician focused financial advisor in today’s complex healthcare industrial complex landscape.

For example, is it business as usual for FAs today; does it fall under the auspices of the Certified Medical Planner™ professional rubric, or is it something else?

Be a pioneer and help shape the industry’s definition of medically focused financial advice by sending us your thoughts on competency tasks and areas of subject matter expertise.

Results

The results will enhance iMBA’s Certified Medical Planner designation, which is designed to help financial advisors address the needs of physicians, medical professionals and all allied healthcare personnel; and help define the role of physician focused financial planning in the coming decade.

Learn More

To learn more about this growth specialty and designation, click here: www.CertifiedMedicalPlanner.org

Assessment

Please be assured that if you take the survey, your responses are confidential; we won’t share your contact information with third parties. Thank you for your participation!

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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How the ME-P Helps Doctors Become and Remain Professionally and Personally Fiscally Fit

 Sponsored: www.CertifiedMedicalPlanner.com

Financial Planning Handbook

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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TESTIMONIAL

In his book Financial Planning Handbook for Physicians and Advisors, Dr. David E. Marcinko, MBA CMP® CFP® provides us with a simple and yet very complete view on the basics of financial planning that every physician should know in order to maximize our chances for success in the financial aspect of our medical careers and personal lives.

The book is well structured, organized and easy to read. Divided in ten chapters, it covers important aspects of personal financial planning such as insurance, home mortgages, retirement plans, auto buying, taxes and more. In an era where doctors must have a solid understanding of the basics of financial management, this book is a must-have on every physician’s private book collection.

Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisors.  This book would make an excellent reference for teaching medical students and residents the basics of monetary management.

I highly recommend this book and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done.

Manuel J. Colón, MD

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Physician’s Update on Dividend-Paying Stocks

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But Some Doctors Ask – Why All the Hype?

By David K. Luke MIM CMPcandidate [www.CertifiedMedicalPlanner.com]

www.NetWorthAdvice.com

In an effort to help the US economy recover, the Federal Reserve has lowered interest rates to historically low levels. Furthermore, the Fed has announced its intent to keep interest rates low until 2014. Classic income-producing investments such as savings accounts and certificates of deposit pay next to nothing.

Borrowing Good – Saving Bad!

Borrowers are being rewarded, but savers are being punished. Low interest rates may have spurred the economy somewhat, but they have been devastating for retired people who have a low tolerance for risk. Physicians, other investors and their advisors are turning toward alternatives that pay higher returns, but these vehicles necessarily carry more risk. Among these alternatives, some investors are considering the purchase of stocks that pay reliable dividends.

Assessment

But, is this an appropriate strategy for mature doctors and similar retirees? What are the potential benefits and drawbacks?

Conclusion

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

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

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

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What Did You Do When the Stock Market was Down?

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Investing Hero or Zero … On Market Timing or NOT!

By Staff Reporters

Here at the ME-P, we believe we have some of the most intelligent and savvy readers in the blog-o-sphere. And – why not?

Most are physicians, nurses and medical specialist of all stripes. Others are CPAs, financial advisors and wealth managers. And, some are medical management and HIT consultants with PhDs and MBAs, etc. More than a few more even have dual and triple degrees and professional designations, like www.CertifiedMedicalPlanner.com

The Question

Accordingly, our friends over at The Finance Buff recently asked:

Q: Do you remember those days last summer when the Dow went down 400 points one day and then it went up 400 points the next day, before it went down another 400 points the following day?

Going Granular

Well – if you do – what did you, or your clients do about it? Did you invest more, stay put, bail out or something else? Go granular on us and your fellow ME-P readers, subscribers and lurkers.

Assessment

Please tell us who you are, what you did during the “flash-crash” a few years ago, or last summer’s mini-meltdown, and how it turned out in hindsight?

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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Health Industry Collaboration and e-Patients

More on Inter and Intra Healthcare Stakeholder Relationships 

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According to Jennifer Tomasik MS [jtomasik@cfar.com], writing in the soon to be released ME-P textbook from iMBA Inc www.MedicalBusinessAdvisors.com: “Healthcare Organizations” [Management Strategies, Tools, Techniques and Case Studies], now in-process from (c) Productivity Press for 2012:

We are in a time of great change in healthcare. No one is certain how the future landscape will unfold, but it is clear that changes in regulation, reimbursement, technology, the economy, and science will significantly impact the work of those clinicians and administrators who dedicate their careers to improving patient care.

More Collaboration Needed

Experience has shown that better collaboration between patients and among the many different parts of the healthcare delivery system holds great potential to improve the quality of care and the relationships of those delivering it. It has also shown that the opportunities to improve collaboration are widespread.

Our focus, therefore, should be to introduce and share a selected set of tools that can be used to improve collaboration along several dimensions:

  • Clarifying roles and authority through decision charting,
  • Understanding the “give” and the “get” needed to establish effective alliances through the current state, and
  • Working jointly to establish and test a set of refined expectations through a physician-administrator compact.

Assessment

In the end, improved collaboration can help medical institutions with everything from inter professional productivity, to patient satisfaction to the most critical service of all: caring for patients and saving lives.

Link: http://www.crcpress.com/product/isbn/9781439879900

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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Are “Financial Advisors” True Professionals or Employed Sales Representatives for Retail Products?

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White House Sides With Sales Reps On Overtime

Dr. David Edward Marcinko MBA CMP™

[ME-P Editor-in-Chief]

www.CertifiedMedicalPlanner.org

As the US Supreme Court is preparing to review the contentious debate about overtime pay for sales reps, the US Solicitor General has filed an amicus curaie, or friend of the court brief, and sided with pharma reps. The move is not surprising, given that the US Department of Labor has, several times, taken a similar step in federal courts around the country where cases were heard.

Far Reaching Implications?

The review is expected to have far-reaching implications for the pharmaceutical industry, and I believe the financial services industry, as well. Why?

Both sectors have been fighting a growing number of cases nationwide over the past several years, but has had mixed results as the issue has continually divided the courts. At the same time, drug makers, Wall Street and broker-dealers have been laying off thousands of sales reps – “financial advisors”, “wealth managers” and stock brokers – as they try to cut costs and alter their business models to prepare for some level of fiduciary accountability.

The Issue

At issue is whether drug reps, and FAs by extension, are exempt from overtime provisions of the Fair Labor Standards Act. The FLSA overtime compensation requirement does not apply to employees who work as outside salespeople, but the law does require employers to pay overtime for hours worked beyond 40 hours a week, unless a FLSA exemption applies.

Link: http://www.pharmalot.com/2012/02/white-house-sides-with-sales-reps-on-overtime/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Pharmalot+%28Pharmalot%29

My Issue

And so, does this mean that most “financial advisors” are really stock-brokers and product pushers after all? At least in medicine, we doctors know what a pharmaceutical rep is – and we understand his/ her roll is to push pharma products, DME and drug sales.

Shouldn’t a salesman – be a salesman – and an “advisor” – be an RIA or RIA rep? I don’t often agree with the White House, but I do on this one.

FAs can’t be independent client advocates – and employees – at the same time

Now, isn’t it time for the public to know that the vast majority of FAs are just salesmen [still SBs], too? Just selling retail financial products to doctors and others; not drugs. After all, FAs can’t be independent client advocates – and employees – at the same time.  And, it appears with this potential filing and ruling; that they truly wish to be the later. Now FAs, admit it!

Assessment

Why do you think FAs are licensed as “registered representatives”? Rarely; a fiduciary among them!

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

A Brief Interview on Investing with Dr. David E. Marcinko MBA CMP™

On Opportunities for Risk Tolerant and Investment Minded Physicians

Sponsored by: www.CertifiedMedicalPlanner.org

By Hope R. Hetico RN MHA [Managing Editor]

This is my second interview with ME-P Founder and Publisher-in-Chief, David Edward Marcinko. Our first formal interview was during the Thanksgiving weekend of 2007. I caught up with him recently on client engagements, in Chicago, Illinois.

And, while he may not always be right; he is never equivocal with his opinions, and is always passionate about them.

HETICO: Well, David, what have you been up to since our last interview?

MARCINKO: The usual; writing, editing, teaching, speaking, consulting engagements and servicing private clients. All noted on this blog forum, of course.

HETICO: So, refresh our readers, and tell us a little bit about yourself

MARCINKO: A doctor, surgeon, and bone and joint lower extremity specialist by training, I took down my medical shingle in 2000 and sold my ASC to become a full-time health 2.0 consultant that never looked back. I’ve also got an MBA degree in marketing and micro-economics, and was a registered BD representative, RIA rep, insurance agent, Series #7, #63 and #65 licensee and, certified financial planner for almost 15 years before eschewing them all. I then started the www.CertifiedMedicalPlanner.com online educational and certification program for physician focused financial advisors and fiduciary medical management consultants. My CV, fingerprints and DNA, are all over this e-publication.

HETICO: So, back on point. What is your investment style and where do you see market opportunities today?

MARCINKO: I am a non-conformist and contrarian by nature; when others zig; I zag. I use ETFs and index funds, and as a strategic investor have a personal ten-year time line, at least. I like cash-on-hand, too.

HETICO: I know you like international investing; when did this proclivity start.

MARCINKO: I did very well investing in long term Federal and state municipal bonds back in the early 1980’s. This was against the investment advice of everyone I spoke to at the time; except my mother – a banker. Interest rates were sky-high, so listening to her was a no-brainer. I then saw an international opportunity right after the Asian contagion crisis back in 1997-98. I lost a bit with Japan, but more than made up most everywhere else. I’m still underweighted in the US, and must admit, I missed the bottom-feeder boat domestically back during the flash-crash of 2008.

HETICO: How have your international products changed over time?

MARCINKO: I used ADRs and index funds, at first, mostly Vanguard. But, I moved to ETFs as they emerged. I stay away from individual foreign or international stocks

HETICO: What kind of foreign assets do you prefer?

MARCINKO: Equities strictly; no foreign bonds or currencies.

HETICO: What about gold?

MARCINKO: Nope, missed the run-up, but I hate commodities based solely on the supple-demand curve.

HETICO: What parts of the world do you see as hot investing opportunities, right now?

MARCINKO: The Middle-East, and Singapore which provide higher dividend returns than most US equities. I’m patiently waiting for Europe to implode.

HETICO: What kind of research do you do?

MARCINKO: I read everything written and online, but try to follow the massive macro-economic trends and demographics. For example, now is not the time to invest in US bonds as IRs are near historical lows, and cannot go much further, I think.

HETICO: Any other domestic opportunities?

MARCINKO: Not that I can see. Horde cash! Maybe domestic equity based REITs with the real estate lows.

HETICO: How often do you adjust your portfolio?

MARCINKO: Every 3-5 years I might buy if the opportunity [screams] presents itself. Generally, we never sell.

HETICO: Do you believe in asset allocation and balanced investment portfolios?

MARCINKO: No. It is the surest way I know to mediocre returns.

HETICO: Do you believe in dollar cost averaging?

MARCINKO: No, it is a theoretical artifice – merely a mechanism to “keep you in the game” so that mutual fund companies, SBs and BDs, RIAs, IAs and FAs can earn commissions, trails, 12b-1 fees and/or AUM percentage revenues, etc. It gets and keeps [your] money rolling into their coffers. And,  it smooths out their cash flow. Remember, DCA is a no brainer – and it is fit for those with no brains.

HETICO: What is your forecast for 2012?

MARCINKO: I’m with Bill Gross, who runs the world’s biggest bond fund at PIMCO, and thinks the global economy and financial markets are at risk in 2012.

HETICO: If you and Bill are correct, what will you do?

MARCINKO: Yawn!

HETICO: Who is your favorite health economist?

MARCINKO: Noble prize winner Ken Arrow PhD, of course. He is the god-father of the industry.

HETICO: Where do you see yourself in 5 or 10 years; or thereafter?

MARCINKO: Well, in five years my daughter will be out of college. In ten years, I see myself doing the same things I do now. And, I just love my engaged clients at: www.MedicalBusinessAdvisors.com Then, perhaps some private philanthropy work.

HETICO: Who is your financial investing hero?

MARCINKO: My colleague and former hedge fund manager Mike Burry, MD.

Link: https://medicalexecutivepost.com/2010/03/24/video-on-hedge-fund-manager-michael-burry-md/

Assessment

Thank you; David!

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Is Dr. Marcinko correct; what do you think about his style and candor? Please review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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


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Is Malta a Hedge Fund Haven?

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Island in the Mediterranean Sea – South of Sicily (Italy)

By Dr. David Edward Marcinko MBA CMP

[Editor-in-Chief]

OK; I’ve written about hedge funds before, on this ME-P and in our www.MedicalBusinessAdvisors.com print publications for various textbooks, handbooks, white papers and journal. And, we discuss the concept in our online educational www.CertifiedMedicalPlanner.org program, as well. Some medical professionals love them, and some financial advisors use them in their work; others do not.

Of course, I’ve written frequently about my colleague – the now retired and newly anointed philanthropist  and uber-hedge fund manager Mike Burry MD; ad nauseam.

Link: https://medicalexecutivepost.com/2010/03/24/video-on-hedge-fund-manager-michael-burry-md/

But, now there is a new wrinkle on the island that I first visited about ten years ago, while on a working vacation

Rising Visibility

Malta–yes, Malta–has quietly leveraged the rising transparency imperative to attract hedge funds. There was a time when the quaint island sought to play on the traditional terrain, offering anonymity and a “laissez-faire regulatory regime,” not to mention very low taxes, as in no capital gains taxes and no taxes on dividends; all while English speaking and USD currency denominated.

Maybe back then, no more today, if this essay is to be believed.

Link: http://www.bloomberg.com/news/2012-01-05/malta-lures-connecticut-hedge-funds-with-300-days-of-sun-aided-by-eu-rules.html

Image 1

Why Malta?

Link: http://www.firstgozo.com/maltafacts.htm

Malta

Assessment

While many leading domiciles for offshore hedge funds remain in the Caribbean–notably the Cayman Islands, the British Virgin Islands, Bermuda, and the Bahamas–the island of Mata is drawing attention, especially from European funds.

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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

On “Financial Planning for Physicians AND their Advisors”

About iMBA Inc Expertise in Healthcare Valuation

iMBA Inc., and the ME-P Team

By Ann Miller RN MHA

MarcinkoAdvisors@msn.com

Ph: 770-448-0769

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The www.MedicalBusinessAdvisors.com is focused solely on appraising medical practices, surgery centers [ASCs], podiatry, optometry and allied healthcare businesses.

Working with our affiliated partners, like the ME-P and others, we are also available for behemoth multi-specialty medical practices, major clinics, hospitals, related healthcare organizations and networks, and PHOs, etc.

We are backed by the expertise of dedicated appraisers and valuation analysts who are trained by the foremost organizations in our industry www.CertifiedMedicalPlanner.org

Practice owners, attorneys and accountants retain us for projects including, but not limited to the following:.

There are a Myriad of Reasons for Obtaining a Medical Practice Valuation and Appraisal Engagement

  • Outright selling-buying
  • Partnership and Associate buy-in / buy-out
  • Mergers and Acquisitions
  • Organic growth tracking
  • Hospital integrations
  • Private and public reporting
  • Financing and Venture Capital
  • Estate and tax planning

Our Capability

We have the ability to provide extensive analysis of value components in healthcare practices and provide appraisals based on business, economic, and market conditions. This involves detailed examination of financials and clinical data in the context of numerous factors including medical specialty, physician supply and demand, payer mix, regulatory environment, regional dynamics, and risk premium.

Assessment

Our methods and approaches adhere to accepted standards of healthcare practice appraisal and utilize direct market data to reach justifiable conclusions.  These are documented in a comprehensive report which is tailored to meet the need of the specific engagement.

BLUNDERS TO AVOID: Medical Practice Valuation Blunders[1]

SAMPLE ENGAGEMENTS: See partial engagement list below.

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Thank you for your consideration

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The One-Woman Physician Investors Should Not Trust

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Why We Should “Run” from the SEC’s Mary Schapiro

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

OK, I’ve opined about fiduciary accountability for stock brokers, FAs and FPs – as well as Mary Schapiro [Chairman of the SEC] before – on this ME-P. And usually, in not so glowing terms!

But now, Mary really chaps my ethical and linguistic sensibilities.

Why I’m So P…… Off!

According to Bloomberg, and Advisor One [a financial services industry trade magazine], the chairwoman is considering something called the “business model neutral” rule that retains proprietary financial products, and brokerage sales commissions.

This concept of ‘business neutral’ is the one sought by many in the brokerage and insurance industry in order to redefine the term ‘fiduciary’ as an enhanced form of ‘suitability’ with opt-out provisions.

But, it is not sought by me, and should not be accepted by physicians.

Definitions

Suitability Rule – According to the Free Dictionary:

A stated or implied requirement by a regulatory body that a broker or investment adviser must reasonably believe that a certain investment decision will benefit a client before making a recommendation to him/her. That is, the broker or investment adviser must act in good faith, and may not knowingly recommend bad investments. Different regulators and self-regulating organizations incorporate suitable rules in different places in their bylaws. Two commonly referenced suitability rules are Rule 2310 for the Financial Industry Regulatory Authority and Rule 405 for the NYSE. See also: Due diligence, Prudent-person rule, Twisting.

Fiduciary Rule – According to the Free Dictionary:

A uniform standard for financial advisors that requires them to put retail customer interests ahead of their own financial interests.

This is clearly a higher duty [level of care] than suitability. Insurance agents, stock brokers, BDs and most “financial advisors” hate it.

Link: http://www.advisorone.com/2011/12/09/reaction-to-schapiro-comments-on-fiduciary-rule-ar?ref=hp

“Suitability on Steroids”

Some pundits suggest we think of this new “business model neutral” rule as “suitability on steroids.”

However, as most of us in medicine know, steroids are not a panacea and are typically used as a quick fix for short term gain, only.

Otherwise, the excessive use of anabolic steroids is bad for our physical health. Just like Mary Schapiro is bad for our fiscal health. But, a Certified Medical Planner™ is a fiduciary at all times http://www.CertifiedMedicalPlanner.org

More: Enter the CMPs

Assessment       

And so, your thoughts and comments on this ME-P are appreciated. I was an insurance agent and certified financial planner for almost 15 years [Series 7, 63 and 65] before I resigned all – in disgust over the fiduciary flap.

Doctors are fiduciaries. I am a fiduciary, a doctor, and a financial advisor. Shouldn’t all physician-investors demand same from their own financial advisors [NASD-FINRA, RIAs, RIA-Reps]?

But hey – I’m just a medical provider.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Financial Planning MDs 2015

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

Front Matter with Foreword by Jason Dyken MD MBA

[BY DOCTORS – FOR DOCTORS – PEER REVIEWED – NICHE FOCUSED]

***

Why I’m Joining the Physician Nexus Medical Advisory Board

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On My Non-Linear … and Sometimes Concurrent Career Path

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

As Medical Executive-Post readers know, I am a big believer in career and change management; evolution if you will. As an entrepreneurial doctor, writer, publisher, speaker, financial advisor, economist, management consultant and business owner, with a non-linear career spanning more than 30 years, I’m acutely aware that to thrive, I must evolve.

Evolution not Revolution

Most of our readers know my career story, but you probably don’t know that even now, my career continues to evolve. For example, I recently accepted a position on the Physician Nexus Medical Advisory Board http://physiciannexus.com/page/nexus-board-of-advisors

THINK: Evolution; not revolution.

Am I Un-Happy?

Why did I embark on this project? Am I giving up my day job at this ME-P? Am I moving on from my business? These are questions I’ve been asked, and I’ve given them all some thought. The nature of these questions signifies a fundamental assumption that, to be considered stable and sane, we must remained attached to “one occupation”, and that if anything changes in that equation, we are surely about to make a move because we are unhappy www.BusinessofMedicalPractice.com

Not so!

Last Gen Parents – Next Gen Son

Don’t believe m? Just ask me about the time I told my last-generation dad and mom I was going to business school, after medical school www.CertifiedMedicalPlanner.org then promptly started an online educational and testing firm for doctors, financial advisors, CPAs and stock brokers. Or; when I sold my ambulatory surgery center – and later still – my private practice, etc! Can you say ballistic?

I added this new patch work to my career quilt because I accepted an opportunity – a chance to do things that I truly love; have engaging clients, speak and write about it. But, don’t worry about me! I’ve got the support of my next-generation wife.

iMBA Inc

And, as we at the www.MedicalBusinessAdvisors.com continue to consult with medical practices to improve their operational results … or with doctors for their financial planning needs, I’m always keeping my eyes open for the next opportunity that catches my fancy.

A Kindred Spirit

Like my colleague Philippa Kennearly MD MPH, over at the Entrepreneurial MD http://www.entrepreneurialmd.com I’m here to argue that the contemporary career of an entrepreneurial physician can and perhaps should be a non-linear projection; it can contain clinical practice AND an Internet business AND writing books AND taking on clients AND seminar speaking and consulting projects AND being part of a family and community.

Just recall, Bill Gates of Microsoft said that most contemporary knowledge workers will follow a career path that changes every seven [7] years. But, I don’t know if he meant doctors, as well?

Assessment

Doesn’t that sound more exhilarating to you than feeling stuck in one gear? Isn’t it time to shift that gear from either … or  to and … and, as Philippa is prone to say?

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Marketing Basics for Financial Advisors and Physicians

On Differences and Similarities

By David K. Luke; MIM

[Investment Advisor]

www.NetWorthAdvice.com

The difference between internal marketing and external marketing for physicians is that internal marketing is the management strategy of improving satisfaction by making patients aware of the positive differences in the physician’s practice –versus- other modern or traditional alternatives that the doctor might externally use [yellow pages, coupons, TV, radio, internet, blogs, etc].

Now, compare marketing with advertising, which attempts to draw patients to the medical practice or clinic using more expensive channel distribution means and/or media messaging.

The “X” Factor

Internal marketing gives the patient “something extra” during the visit that tends to make them pleased, satisfied – or better yet – delighted!

In show business, Simon Cowell calls this something extra the “X” factor.

Whether it is a “Patient Bill of Rights” or just making sure that patients are treated fairly, and with respect throughout the process, turns the patient into a practice advocate instead of a patient from hell.

Improved listening/communication can come in the form of an attentive and caring human ear, enhanced bedside manner, or technology like P[C]RM (Patient {Client} Relationship Management) tools and/or eMRs, for example.

Sloppy Medical Office Procedures

Having office staff involved, by noticing improvements, can also help with the implementation of a successful internal marketing strategy. Sloppy office procedures can be cleaned up, scheduling access management can be revamped, and any administrative mix-ups can be avoided.

Negative practices such as “we enforce a minimum $50 office visit fee” should be stopped, as this casts a negative attitude on all patients, not just future deadbeats.

An effective P[C] RM strategy can increase patient satisfaction and be inexpensive to implement and maintain, especially in light of modern advertising tools for medical practices.

Financial Advisor Comparisons 

A physician’s internal marketing program is comparative to an FA’s internal marketing program, in that both methods are much more cost effective and yield better results than traditional external marketing or advertising.

For an FA, the practice of encouraging referrals can be done discreetly without making the existing clients uncomfortable.

An FA practice that is “referable” is one in which there are consistent standards and procedures in place. This creates a comfort factor with existing clients and assures them that when they refer their friends and family they will also receive consistent quality treatment.

Assessment

An FA can implement procedures similar to a medical practice by training staff to point out and recognize office procedures that might be improved. Letting clients know they are appreciated and that referrals are accepted sounds like obvious advice, but is often ignored by too many Financial Advisors, and even doctors.

Editor’s Note: David K. Luke is currently enrolled in the online www.CertifiedMedicalPlanner.org chartered professional designation program.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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

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Saying “Thanks” to Patients and Clients

On Doctors and Financial Advisors Saying “Thank You”

By ME-P Staff and Reporters [A family of communication and educational companies]

In 1621, our settlers acknowledged a large autumn harvest feast as one of the first Thanksgiving celebrations in the colonies. But, it wasn’t until 1863, in the midst of the Civil War, that President Abraham Lincoln proclaimed a national Thanksgiving Day to be held each November. Ever since, Americans have used this gathering time to be with family and friends and reflect on those things we are most thankful for in our lives.

Note: click  the image

So here we are, ramping up to celebrate the anniversary of that first Thanksgiving some 148 years ago. This year, let’s take the same reflective approach and apply it to our ME-P work worlds.

For example, whether a doctor, nurse, CXO or financial advisor, when was the last time:

  • You expressed gratitude to your key patients, hospitals, employees or clients?
  • You recognized a newer prospect referral for sending a patient or client your way?
  • You were truly grateful for those patients and clients who keep your medical practice, financial advisory or medical management business viable – and you showed it?
  • You said “thank you” to one of your referring physicians, attorneys or accountants?

Assessment

This time of year is a good reminder to show your appreciation to patients, customers, vendors and clients—not from only a monetary perspective, but for all they contribute to your relationships.

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Our Question

As so, what are some of the helpful and creative ways that you say “thank you” this season for all your loyal fans?

Of course, we also extend our gratitude and say “thanks” to all clients, readers, providers, sponsors, advertisers and subscribers to this Medical Executive-Post

Happy Thanksgiving Weekend 2011, and thank you for your continued support!

Conclusion                

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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On Healthcare Collaboration Trends

A Lay Perspective

By David K. Luke MIM CMP

[Investment Advisor]

http://www.CertifiedMedicalPlanner.org

Collaboration within healthcare has sprung from the general body of health communication research; ie., crowd-sourcing, etc..

And, there are a number of other emerging trends, visible to the lay man or woman, in the patient collaboration arena today.

1. Cross-Discipline Communication Teams

One trend is the formation of cross-discipline communication teams among health care professionals.  Different disciplines in pairs, small groups and teams now collaborate directly with each other. This is an important development in improving the healthcare delivery process to the patient.

Typically health care providers tend to identify strongly with their own discipline and likewise cross collaboration may be very difficult. But this trend is developing so that Nurses, Social workers, pharmacists and others work with physicians with a full realm of issues. Likewise we see now the Nurse/Physician collaborative, Nurse Practitioner/Physician Collaborative, Social Worker/Physician, Pharmacist/Physician and even Physician/Physician collaborative groups.

2. Clinical Health Care Teams

A second trend in patient collaboration is Clinical Health Care Teams.  A team approach to care and measurable patient outcomes has shown in studies (Cooke, 1997; Cooley, 1994: Fagin, 1992, et al.) as improving overall care for patients. These multidisciplinary teams facilitate and improve training of students in medicine and nursing and other related fields as well.

3. Informal Backstage Communication

Finally, a third emerging patient collaborative trend is the increase is informal backstage communication.

Typically communication in the healthcare setting regarding the patient has been done among the team members in a team meeting setting for a one to two hour collaboration session.

Now we see the emergence of the backstage regions such as the break rooms, hallways, clinic computer desk, work tables, photocopy rooms, and offices. While these encounters between team members are often fleeting and “messy”, the environment within a practice setting can be consciously created to allow for this increased interaction among team members that will certainly improve the care of the patient.

Of course social media and e-communication facilitates this trend.

Conclusion                

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

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

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

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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How Good Looks Lead to Higher [MD] Paychecks

Even for Medical Professionals?

DEM 2

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.org

[Editor-in-Chief]

Beauty seems like enough of a reward in and of itself, but a wealth of research reveals that it comes with extra perks too.

Prettier people earn more money, find higher-earning and more attractive spouses, and even get better mortgage deals!

And, now that more than 40% of young new physicians are seeking employment, do looks really matter?

Assessment

Source: www.onlinembaprograms.net

Conclusion                

Is this controversial thought true for doctors and learned medical professionals? How about publishers and editors? Do you have any real-life examples to share with the ME-P? Your thoughts and comments are appreciated.

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

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

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

Our Other Print Books and Related Information Sources:

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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Financial Services Career Evaluation [An Opinion and Voting Poll]

Would You Continue to Work if Financially Independent?

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By staff reporters

Studs Turkel, in his outstanding book Working, made the comment that work is the mechanism by which many of us get our daily bread and our daily purpose.

If this is to be the case, then the modern financial services sector may need a lift to offer something more than a paycheck. This may especially be true when one considers the recent shenanigans on Wall Street, the slow decline of the broker-dealer business and product model – and considering that RIA, fiduciary and/or niche marketing models are slowly rising http://www.CertifiedMedicalPlanner.org

A General Survey

The Wilson Learning Corporation surveyed 1,500 laypeople, asking “If you had enough money to live comfortably for the rest of your life, would you continue to work?

Seventy percent said that they would continue to work, but 60 percent of those said they would change jobs and seek “more satisfying” work.

But more specifically, regardless of whether you are called a Financial Advisor, Stock-Broker, Wealth Manager or Financial Planner – how about you?

Assessment

If financially independent, would you continue to be a financial consultant [regardless of nomenclature]?

Conclusion

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

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

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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On Financial Advisors Becomming Certified Medical Planners™

Introducing

CERTIFIED

MEDICAL PLANNER 

  Now accepting matriculation applications from Financial Advisors, MBAs, CPAs and all RIAs!

  Live Online Matriculation Leading to a

Chartered Professional-Designation

Certified Medical Planner 

Attract, retain and better serve physicians and other medical professional clients.

Become a Certified Medical Planner™ –OR- just succeed like one!

 www.CertifiedMedicalPlanner.com

###

How to Select a Property and Casualty Insurance Agent

Eschewing Conventional Wisdom

[By Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

In my travels, and various consulting engagements, I am often asked how to select a good PC agent. As a former insurance agent myself, I know what is required for my medical colleagues. And, there is no doubt that a good property and casualty (P&C) agent is needed to protect the physicians’ home and medical practice business entity, etc.

No Dedicated Agents

The P&C agent should not be dedicated to a single company, but have an array of carriers with which the home or practice can be placed.  I opine thusly even though most insurance companies will offer a discount if you place multiple coverage with them.

Select “Best of Breed”

However, this may not be as beneficial as insuring each need with a specialist. So, do not hesitate to place different types of coverage with different insurers. Selecting the “best of breed” may be more work; but it also may be more beneficial when a claim is made.

Assessment

Remember, by agency law, and definition, P&C agents are not fiduciaries.

Conclusion

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

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

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Are Health 2.0 and Financial Services 2.0 Organizationally Related?

Similar Business Models Emerging!

By David K. Luke, MIM

Investment Advisor

http://networthadvice.com

Defining Health 2.0

Health 2.0 is healthcare with the full involvement of the patient and the doctor. New web technologies, enabled by information, software, and social networking help increase participation and openness between the players. This will permit health care professionals to work in a more suitable “patient-centric” demand driven environment. Health 2.0 is evolving fast as the technology evolves.

Defining Financial Services 2.0

The same technology deployment changes and increased public involvement are prevalent with Financial Services 2.0, including a quickly morphing investor driven landscape creating a more “investor-centric” atmosphere.

Tribulations and Detractors on Both Sides

The move to 2.0 in healthcare and financial services is proving to be beneficial to all parties, but not without tribulations and some detractors.

In Healthcare

Within healthcare, from the patient’s perspective, the ability for patients to have ready access to their medical records, review doctor’s notes, and engage in the process is refreshing and liberating. Older doctors may be unwilling to adapt their practices, however. Many practices are not equipped as strategic business units, which is required now to deal with the patient and is becoming the new norm. Practices will need to evolve and healthcare providers will need to adapt.

For example, nearly 7 out of 10 physicians in a recent study by The MEDSTAT Group and JD Power and Associates considered themselves “anti-managed care” indicating unhappiness with the financial reimbursement system. Some physicians are packing their bags and moving out of practice, into more lucrative business ventures and other pursuits. One criticism of the new Health 2.0 is that it is one more paradigm, one more monkey on the backs of already exhausted physicians.

Another criticism is that some patients are not equipped with the knowledge or experience to interpret correctly all the newly available information, making it difficult for physicians to implement a proper course of action with the patient.

Nonetheless, early adopting physicians to Health 2.0 are having success and utilize e-mail office visits, video-conference appointments, and matching online patient visits with convenient neighborhood locations. The wise physician realizes that Health 2.0 is here to stay, and must be confronted and dealt with.

In Financial Services

Adoption of the new technologies within Financial Services 2.0 has been rapid. The number of Financial Advisors (FA) in the United States has started to shrink as the end investor is increasing access to information and making more decisions without intermediaries. Advisors that are surviving, indeed thriving in this environment are adapting and implementing new technologies. Interactive websites with video, account and investment option access, and reductions in transactions costs while increasing services all seem to benefit the new consumer in Financial Services 2.0. Advisors that are slow to adapt criticize the ease with which investors can now make investment decisions often at their own peril.

Assessment

Some players on both sides of the issue believe that the transaction cost savings touted by new “do it yourself” investing and medical information websites may not be worth the potential [many fold] losses that await the inexperienced investor or patient.

As with physicians and the new realities of Health 2.0, the wise FA is adapting their practice to Financial Services 2.0 not just to cope but also to thrive.

Editor’s Note: David K. Luke is currently enrolled in the online http://www.CertifiedMedicalPlanner.org chartered professional designation program.

Conclusion

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

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

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“Health Care Organizations” [Announcing our Newest Print Book for 2012]

Management Strategies, Operational Techniques, Tools, Templates and Case Studies [in-progress]

By Dr. David Edward Marcinko; MBA CMP

By Prof. Hope Rachel Hetico; RN MHA CMP

Price:  $69.95 est.
Cat. #:  K13750
ISBN:  9781439879900
ISBN 10:  1439879907
Publication Date:  April 15, 2012 est.
Number of Pages:  400 est.
Binding(s):  Hardback

TABLE OF CONTENTS [tentative] 

  1. Market Competition in Healthcare [Understanding the Current Strategic Eco-System]
  2. Medical Career Development [Transformation of Next-Generation Physician Executives and Leaders]
  3. Medical Process Strategic Improvement [Tracking Care with Outcomes Reporting] 
  4. Capital Formation Strategies for Hospitals [Institutional Types, Essentiality and Governance]
  5. Hospital Revenue Cycle Management [Strategic Monitoring and Augmentation] 
  6. Managing Health Information Technology [Exchanging Patient Data – The Benefits and Rewards]
  7. Strategies for Health Information Technology Security and Privacy [Understanding the Rules, Regulations, Penalties and Recovery Efforts]
  8. Lean Six Sigma Healthcare Operations [Improving Healthcare Quality]
  9. Strategic Financial Management Implications of the USA PATRIOT and Sarbanes-Oxley Acts [Health Policy for Affected Hospitals and Healthcare Organizations] 
  10. Collaboration to Improve Operating Performance [Opportunities are Widespread] 
  11. Healthcare Supply Chain Inventory Management [Data Capture, Just-in-Time Strategies and Economic Order Quantity Analysis]
  12. Improving Hospital Flow Through Efficiency, Operations and Logistics [Seeking Leaner and Faster Organizations with Sustainable Improvements]

Pre-Order Now

In-Process from: (c) Productivity Press 2012
http://www.crcpress.com/product/isbn/9781439879900

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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Is the Mutual Fund Company “Invesco” Dissing Podiatrists?

Attacking One of Us = Attacking all of Us

By Ann Miller RN MHA

[Executive-Director]

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Dear ME-P Readers, Subscribers and Visitors,

As you know, here at the Medical Executive-Post, we champion all hard working, honest and ethical medical professionals, regardless of specialty or degree designation. From the ME-P corporate executive suite, to the mailroom, we appreciate their laborious ministrations under increasingly difficult cultural, political and financial conditions on behalf of the US citizenry.

And so, it was with much dismay when this new advertisement from the behemoth mutual fund company Invesco, headquartered right here in Atlanta GA, was brought to our attention. Rest assured. We are not amused and request your input!

You Input Requested

Do you agree with the Ad? Is it an attack on one medical specialty – or on all of us? Would your opinion differ if the ad mentioned a proctologist – or a dentist? How about a brain surgeon or a nurse? Is the dated impression of doctors being on the golf-course still accurate?

More importantly, does the ad affect your impression of Invesco as a contemporaneous company aware of the modern Health 2.0 culture, or a backward thinking dinosaur resting on its [glorious or in-glorious] past?

Is it Time to Close the Door on Invesco?

Are they Aware?

Do you think that the huge and costly marketing department at Invesco is is even aware that our iMBA Inc sponsored, and ME-P promoted textbooks and handbooks, dictionaries, white papers and CD-ROMs on investing, financial planning, insurance, and risk and wealth management for physicians, was largely written by medical professionals of all stripes? Many holding dual degrees and designations like MBA, CFP®, CMP™, JD, MHA, CFA, etc.

Link: http://www.CertifiedMedicalPlanner.org

Or, that they have been used in [non-clinical] continuing education programs for medical professionals, for more than a decade?

Of course, this includes allopaths, osteopaths, podiatrists, nurses, physical therapists and other related members of the healthcare ecosystem? After all, it often takes a team to treat a poly-systemically ill patient.

Link: www.BusinessofMedicalPractice.com

Assessment

Feel free to contact Invesco directly and tell em’ what you think about their new ad campaign [positive or negative]:

Inveso Client Services:

  • Calls within the United States 800.959.4246
  • Calls outside of the United States 713.626.1919 (Call Collect)

Hours of Service – Monday-Friday, 7:00am-6:00pm CST; subject to change due to NYSE holidays or early market closings.

Contact Link: https://www.invesco.com/portal/site/us/menuitem.33e9ce03dea2c250a83af864f14bfba0/

Industry Indignation Index: 65/100 [probably smelly]

Conclusion

Over the next few weeks we will aggregate your thoughts and may report back to you, and Invesco, about the results. Till then, be sure to also tell us what you think. right here? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

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“Springing” and “Suspending” Advanced Medical Directives

On Well-Know and Little-Know Provisions

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.org

Financial Advisors and attorneys are well aware of various “immediate” and “springing legal directives”, such as springing power of attorney, springing living wills, etc.

“Springing” Advanced Directives

But, what about springing advanced medical directives? Yep! These too not only spring into place, when needed, but can also be suspended?

For example, suspension of advanced medical directives during surgical procedures is possible. But, once out of surgery [time-limited], they would immediately spring back into effect!

Assessment

Financial Advisors, clients and patients should know – and inquire – about the exact time-frame of springing medical directives and related suspensions.

Learn More:

http://www.latimes.com/health/la-he-health-411-20110613,0,62844.story

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

LEXICONS: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

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What is the Point of Financial Planning [Pod Cast]?

A Video and Audio Survey

By Staff Reporters

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Question

What’s the point of financial planning?

One Answer

Read WSJ’s post from Richard Reyes and comment below to share what you think the point is.

Assessment

PodCast link: http://www.vimeo.com/22892025?ab

Conclusion

And so, your thoughts and comments on this ME-P are appreciated.

Is financial planning different for doctors, as we contend here at the ME-P? Do we need a separate educational track and designation for healthcare, like: www.CertifiedMedicalPlanner.com ?

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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Understanding Over the Counter (OTC) Markets

A Decentralized, Dealer-2-Dealer Market

By Dr. David Edward Marcinko MBA

[Publisher-in-Chief]       

www.CertifiedMedicalPlanner.com

Securities are bought and sold every day by physicians and other investors who never meet each other. The market impersonally enables transfer (or sale) of securities from individuals who are selling to those who are buying. These trades may occur on an organized exchange such as the New York Stock Exchange, or, a decentralized, dealer to dealer market, which is called the over-the-counter (OTC).  Any transaction that does not take place on the floor of an exchange, takes place over-the-counter.

A Negotiated Market

The over-the-counter market is a national negotiated market, without a central market place, without a trading floor, composed of a network of thousands of brokers and dealers who make securities transactions for themselves and their customers. Professional buyers and sellers seek each other out electronically and by telephone and negotiate prices on the most favorable basis that can be achieved. Often, these negotiations are accomplished in a matter of seconds, there is no auction procedure comparable to that on the floor of an exchange.

The over-the-counter market is far the largest market in terms of numbers of securities issues traded. There are over 40,000 issues on which regular quotations are published OTC, while there are less than 5,000 stocks listed on all securities exchanges. There are frequently days when the reported volume of over-the-counter trades exceeds that of the NYSE. What really is the over-the-counter market? Is it where securities of inferior quality trade? Here is a list to remember of the types of securities traded exclusively over-the-counter:

  • All Government bonds .
  • All municipal bonds.
  • All mutual funds.
  • All new issues (primary distributions).
  • All variable annuities.
  • All tax shelter programs.
  • All equipment trust certificates.

Of course, the OTC market is also where all of the “unseasoned” issues are traded and most of them are quite speculative, but there certainly are many high quality issues available over-the- counter. Now, let’s take a look at how this over-the-counter market works.

The Market Maker

Whereas, the “main player” on the exchange is the specialist, his OTC counter part, in terms of importance, is the market maker. In the over-the-counter market, many securities firms act as dealers by creating and maintaining markets in selected securities. Dealers act as principals in a securities transaction and buy and sell securities for their own account and risk. Since they do not act as agents or brokers but instead as principals or dealers in securities transactions, they do not receive any commission for their services but instead buy at one price and sell at a higher price making a profit from “mark-up” on the security price. A dealer is said to have a position in a stock when he purchases and holds a security in his inventory. He, of course takes a risk that the market price of the security he holds may decline in value. This is how dealers make money; they buy wholesale and sell it retail, and the physician investor pays retail.

The OTC market bears little resemblance to the one of the mid-sixties. The major difference has been the electronic technological advances as embodied by the NASDAQ system. NASDAQ stands for National Association of Securities Dealers Automated Quotation system. Back in 1966, if you wanted to find out who was the market maker in the particular security you would go to a brightly colored stack of papers called the pink sheets, containing a listing, alphabetically, of over-the-counter stocks and underneath each issue is listed the name of one or more market makers, securities firms willing to trade that stock. After each firm name is the firm’s telephone number and a ‘bid and ask price”, that is, an approximate price representing what the dealer is asking for the stock and is bidding for the stock. 

Back 35-40 years ago, the only way of locating a market maker was by using the pink sheets, while O-T-C traded corporate bonds are quoted on yellow sheets. Under certain conditions, it could take a good deal of effort to try to get the best deal. Today, with the computer that sits on doctor’s desks, or a mobile device or smart-phone, you can push a few buttons and instantaneously see the best bid and the best offer that exists right now on over 5,000 of the most active over-the- counter stocks. Not only that, you can pull up the names of every market maker in that particular stock and the actual (firm) quotes on those securities right now.

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Electronic Sources of Securities Information

Level 1 service, available on the stock broker’s desk top, provides price information only on the highest bid and the lowest offer (the inside market). No market makers are identified, and since this is an inside quote, it may not be used by the registered representative (stock broker) for giving firm quotes. 

Level 2 service provides a doctor subscriber with price information and quotation sizes of all participating registered market makers. When a trader, or medical investor, looks at his computer screen on Level 2, he sees who’s making a market, their firm bid – or – ask; and the size of the market. One can get firm calls from level 2 information.

Level 3 service takes it one step further; and allows registered market makers to enter bid and ask prices (quotes) and quotation sizes into the NASDAQ system and to report their trades. This is the level of service maintained by market makers.

Conclusion

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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Financial Life Planning Defined for Physicians and Advisors

Integrating Financial Planning, Practice Management and Life

By Dr. David Edward Marcinko MBA, CMP™

www.CertifiedMedicalPlanner.com

Life planning has many detractors and defenders. Formally, it has been defined by Mitch Anthony, Gene R. Lawrence and Roy T. Diliberto of the Financial Life Institute, in the following trinitarian way.

Financial Life Planning is an approach to financial planning that places the history, transitions, goals, and principles of the client at the center of the planning process.  For the financial advisor or planner, the life of the client becomes the axis around which financial planning develops and evolves.

Other definitions are: 

  • Financial Life Planning is about coming to the right answers by asking the right questions. This involves broadening the conversation beyond investment selection and asset management to exploring life issues as they relate to money.
  • Financial Life Planning is a process that helps advisors move their practice from financial transaction thinking, to life transition thinking. The first step aiming to help clients “see” the connection between their financial lives and the challenges and opportunities inherent in each life transition.

But, for informed physicians, life planning’s quasi-professional and informal approach to the largely isolate disciplines of financial planning and medical practice management is inadequate. Today’s practice environment is incredibly complex, as compressed economic stress from HMOs, financial insecurity from Wall Street, liability fears from attorneys, criminal scrutiny from government agencies, IT mischief from malicious hackers, economic benchmarking from hospitals and lost confidence from patients all converge to inspire a robust new financial planning approach for medical professionals. Now, add politics and the ACA of 2010.

Our Approach

The iMBA approach to financial planning, as championed by the Certified Medical Planner, integrates the traditional concepts of financial life planning, with the increasing complex business concepts of medical practice management. The former are presented in our textbook on financial planning for doctors. And, the later is in our companion book: “The Business of Medical Practice” www.BusinessofMedicalPractice.com

Others on risk management and insurance; accounting, tax and investing; retirement, practice succession and estate planning, are planned in our future iMBA Handbook series for physicians and their advisors www.MedicalBusinessAdvisors.com

Example

For example, views of medical practice, personal lifestyle, investing and retirement, both what they are and how they may look in the future, are rapidly changing as the retail mentality of medicine is replaced with a wholesale philosophy. Or, how views on maximizing current practice income might be more profitably sacrificed for the potential of greater wealth upon eventual practice sale and disposition. Or, how the ultimate fear represented by Yale University economist Robert J Shiller, in “The New Financial Order”: Risk in the 21st Century, warns that the risk for choosing the wrong profession or specialty, might render physicians obsolete by technological changes, managed care systems or fiscally unsound demographics.

Assessment

Yet, the opportunity to re-vise the future at any age through personal re-engineering, exists for all of us, and allows a joint exploration of the meaning and purpose in life. To allow this deeper and more realistic approach, the advisor and the doctor must build relationships based on trust, greater self-knowledge and true medical business and financial enhancement acumen.

Conclusion

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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Meet Speaker Dr. David Edward Marcinko MBA

Management Expert, Social Media Pioneer, Journalist and Financial Advisor

www.BusinessofMedicalPractice.com

I am available for a limited number of speaking engagements each year. As social media’s leading integrated voice for medical and financial service professionals, the ME-P voice was noted by the WSJ.com in 2009, which said thatThis website is packed with great information.” And, medical information technology  and eMR guru Alberto Borges MD recently opined You do have an exceptional website”. 

The ME-P’s Reach

With over 250,000 visitors, the ME-P is among the web’s most influential and prominent platforms. I frequently discuss the precarious intersection among medical practice management, financial services, health economics and related social media in keynote speeches, panel discussions, and media interviews. 

Journalist

I also use my two decade long medical, surgical, business management and financial advisory practice and journalistic experiences to engage the private practice community, culminating in the third edition of our book: The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors].

Locale

I am based near Atlanta, GA, so travel for speaking opportunities is not problematic and very inexpensive.

Curriculum Vitae

Here is my CV: DEM Formal CV

Please contact me if you’re interested in having me engage your divese audience: MarcinkoAdvisors@msn.com

Sincerely,

Dr. David Edward Marcinko; MBA

Certified Medical Planner™
www.CertifiedMedicalPlanner.com

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Healthcare Organizations: www.HealthcareFinancials.com

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The Uniform Prudent Investor Act versus Fiduciary Accountability

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A Primer and Review for Financial Advisors

By Dr. David Edward Marcinko MBA, CMP™

www.CertifiedMedicalPlanner.org

More than a decade ago Charles L. Stanley, CFP™ gave an overview of the legislation and highlights areas of change for financial advisors and planners and to the financial services industry. To date, the Uniform Prudent Investor Act (UPIA) has been enacted in most states. Essentially, the act changed the legal criteria for “prudent investing” for trusts. All assets owned by a trust are considered “investments” for purposes of the Uniform Prudent Investor Act. Consequently, if a trust owns a life insurance policy or an annuity, it is considered an “investment” for purposes of the UPIA. Trustees and their advisors are subject to the act.

Background Review

The UPIA (California Probate Code Article 2.5) was adopted by the Uniform Conference of Commissioners on Uniform State Laws in 1994. When determining whether or not certain investing is “prudent,” the standard is applied to the whole portfolio rather than to individual investments.

The UPIA radically changes the analysis of risk. The UPIA considers that risk is unavoidable. For example, fixed income instruments carry the risk of loss of purchasing power, even though the principal may not be reduced in terms of real numbers. Risk is often desirable so long as it is sufficiently compensated. The UPIA seeks to compel the trustees to analyze the trade-offs between risks and returns, taking into consideration the needs and objectives of the trust.

Restrictions Reduced

The restrictions on what type of investments can be held in trust have been eliminated. The trustee can invest in anything that plays an appropriate role in achieving the risk/return objectives of the trust and that meets the other requirements of prudent investment. The trustee’s duty to diversify trust assets is codified in the UPIA. It is now recognized that proper effective diversification may enhance returns and/or reduce risk at the same time.

The UPIA rejected the traditional trust rule that generally prohibited “delegation of duty” by trustees, especially the duty of investment of trust assets. Delegation is now permitted, subject to safeguards. Agents are now made liable if they do not follow the new law.

What Must a Trustee Do to Comply with the Act?

According to Stanley, to comply with the UPIA, trustees must review trust assets and make and implement decisions to either keep or discard assets in order to bring the trust portfolio into compliance with the purposes, terms, distribution requirements, and other circumstances of the trust:

  • The trustee must diversify the assets of the trust unless it is prudent not to do so (16048). For example, it would not be acceptable for the trust to hold all municipal bonds.
  • The trustee must either comply with the Act in full or have the trust amended to restrict the requirements to diversify trust assets.
  • The trustee must delegate if he or she believes that he or she doesn’t the expertise to perform certain functions, this is particularly anticipated in the area of investment management. The trustee is expected to document all of the above to be available for review either by beneficiaries and/or courts should they become involved. This includes a written Investment Policy Statement. The act doesn’t specifically require this, but how would one prove they had been acting as a prudent trustee without documentation?
  • The trustee must periodically review the circumstances, assets and any professional delegates whom he or she has retained to assist him or her. The portfolio must be periodically rebalanced to maintain the established risk/reward characteristics identified in the Investment Policy Statement. This is not specifically stated, but is implied in ¤16047(b) and is a part of proper portfolio management under Modern Portfolio Theory. The act requires the costs of management to be “reasonable.”
  • The trustee must deal impartially with beneficiaries when there are two or more beneficiaries and must invest impartially, taking into account the differing interests of the beneficiaries.

Note: In most states, trust language can draft the trustee out of any and all requirements of the Uniform Prudent Investor Act. Many attorneys are doing this. So check trust language carefully.

Assessment

This essay is not a “final answer” in regard to compliance with the Uniform Prudent Investor Act. Financial advisors should consult with a competent attorney if you have any questions about a specific application with a specific physician investor or other client.

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

Conclusion

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Do Physician Investors and/or their Financial Advisors Use and Abuse Modern Portfolio Theory?

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The Cultural Clash of Passivity versus Activity

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

Ninety-three year old Professor Harry Markowitz PhD, coined the phrase “modern portfolio theory” [MPT] and concluded that investors are rewarded for taking certain risks but may not get rewarded for taking others. He developed the notion of an “efficient frontier” for different groups of asset classes and the idea that the higher the expected return, the higher the risk.

The Brinson, Hood, Beebower Study

In their 1986 study, Brinson, Hood, and Beebower attempted to measure three investment activities: (1) asset class selection, (2) market timing, and (3) security selection. They concluded that asset class selection had, by far, the greatest effect on the risk/return characteristics of a portfolio (some 93.6% of performance). But the most startling conclusion was that, if left alone, investment policy would have produced a higher average return than when market timing and security selection were taken into account. These latter factors actually reduced the average return over a 10-year period.

The Fama & French Study

In 1982, Fama and French found that three factors—market exposure, company size, and “value”—were systematic risks that explained the vast majority of equity market returns. “U.S. small-cap value stocks” is therefore a discreet asset class possessing all three of these systematic risks.

Most physicians and financial advisors are aware of modern portfolio theory but some fail to apply the principles to actual investor situations. Three examples: (1) using erroneous asset-class definitions, (2) using actively managed funds, and (3) relying on market timing. The abuse of modern portfolio theory can create portfolios loaded with latent risks that, on the surface, appear benign.

Not all Agree

Not everyone is in agreement with modern portfolio theory. Some detractors agree in principle, recognizing, for example, that “value” stocks have had higher returns than “growth” issues but they cite the cause as “mispricing” rather than risk.

Assessment

Institutional investors have gradually increased their commitment to passive strategies from virtually zero 20 years ago to 30% or more in the last decade [Think: Vanguard].

Individual and physician investors, on the other hand, have less than a 5% commitment.

Note: “Modern Portfolio Theory: Fact or Fiction?,” Gerard F. Stellwagen and Robin P. LaCouture, NAPFA Advisor, July 1997, pp. 1–7, National Association of Personal Financial Advisors for Fee-Only Financial Advisors.

Conclusion

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A Doctor-Financial Advisor Makes the Case for Stock-Market Timing

Do a Growing Number of Stock-Market Timers Outperform?

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.com

[Publisher-in-Chief]

Money management styles tend to fall in and out of favor in cycles. When the market goes through a sustained bull market, buy-and-hold becomes the proclaimed path to investing success as I have opined previously. But, when the market enters a bear phase, like the flash crash of 2008-09, there is renewed belief in market timing as I now try to explain.

The Studies

And yet, studies of actual results of professional money managers using market-timing techniques reveal that the average timer’s results, like the average mutual fund, slightly lag behind the market indexes. But a growing number of timers consistently outperform the market over a full market cycle. When risk-adjusted return is used as the standard to measure performance, even the average market timer outperforms the market by a notable margin. A study of 25 market timers by Wagner, Shellans, and Paul (1992) during the period 1985–1990 (both bull and bear) shows that the level of risk assumed by the average timer was 40–60% below the S&P 500, even after subtracting fees, and the returns were comparable to the S&P 500.

Marketplace Phases

History has shown that starting from the market’s last high water mark, the market typically goes through three phases: (1) a correction, (2) a recovery to breakeven, and (3) a move to new highs. A study of the 108-year period from 1885 to 1993 reveals that the average correction phase consumed 32% of the time period and the return to breakeven exhausted an additional 44%. The market spent only 24% of the time moving to new highs. This is the only time that typical buy-and-hold investors saw their investments appreciate. This makes the stock market an extremely inefficient money-making vehicle.

Since the market timer who sold at the top will have more money at the bear market bottom than the buy-and-hold investor, the study indicates that the timer may have between 26% and 54% more to invest on the upswing. The study also shows that a timer does not have to be perfect in discerning entry and exit points. In fact, he or she can miss 20% of the advance, participate in 20% of the decline, and lose money as much as 47% of the time and still have an average gain equal to the net average gain for the buy-and-hold investor.

Assessment

Of course, it is quite a feat to obtain all the returns attributable from the buy-and-hold strategy while being in the market about half the time. 

Note: “Why Market Timing Works,” Jerry C. Wagner; The Journal of Investing; Summer of 1997, pp. 78–81, Institutional Investor, Inc.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Did I make my case? Are you a market timer or buy-hold strategist; and why? Did this strategy work until the market meltdown of 2008-09; how about since then? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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Practice Management: http://www.springerpub.com/product/9780826105752

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Do SPDRs Yield Tax Advantages?

How about Trading Efficiency?

By Dr. David Edward Marcinko; MBA CMP™

www.CertifiedMedicalPlanner.com

[Publisher-in-Chief]

The bull market generated large mutual fund capital gains distributions at the end of 2007; and maybe again for 2011. Accordingly, tax efficient mutual funds are getting more attention as a result. Also growing in popularity is Standard & Poor’s Depository Receipts (SPDRs), sponsored by and traded on the American Stock Exchange (AMEX). SPDRs are trusts that own stock positions that match a particular index, like the S&P 500. Investors then buy shares of the trust.

The Facts about SPDRs

Investors sell their shares of SPDRs on the Exchange rather than redeeming shares through the mutual fund. The trust does not sell stock to make cash redemptions. This avoids most of the capital gain distributions that annoy long-term investors. As a prospectus from the American Stock Exchange notes:

In-Kind Redemptions

While no unequivocal statement can be made as to the net tax impact on a conventional mutual fund resulting from the purchases and sales of its portfolio stocks over a period of time, conventional funds that have accumulated substantial unrealized capital gains, if they experience net redemptions and do not have sufficient available cash, may be required to make taxable capital gains distributions that are generated by changes in such fund’s portfolio. In contrast, the ‘in kind’ redemption mechanism of SPDRs may make them more tax efficient investments under most circumstances than comparable conventional mutual fund shares.

Fund Trading and AMEX Insight

The AMEX prospectus not only provides a detailed look at the in-kind redemption mechanism of the SPDRs, which is important to their tax efficiency, it also offers analysis of the economics of intraday SPDRs fund trading. Unlike mutual funds, for which prices are determined at the end of each trading day, SPDRs can be bought or sold at anytime during the day at the spot price. SPDRs trade like a stock, so the account does not need futures approval and shares can be sold short or margined. The SPDRs shares track the futures closely.

Assessment

The reservation that physicians and all investors, as well as we financial advisors, have is simply “Are the SPDRs expensive to trade?” The AMEX prospectus does not answer that question in so many words, but it provides the data needed to make a cost calculation. In 1996, the bid/asked spread on the SPDRs was 1/16 or less more than 62% of the time and 1/8 or less about 95% of the time. Each investor can make his or her own commission assumptions, but the range on the S&P 500 exceeded 0.5% more than 75% of the time and was greater than 1% approximately 25% of the time. With such a narrow bid/asked spread relative to the average move in the shares and a reasonable level of commissions, it is often easy to get in or out of the fund at a price appreciably better than closing NAV.

Assessment

What are these spreads today? Copies of the prospectus and other information on SPDRs are available by calling 1-800 THE AMEX

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Do you use SPDRs; why or why not? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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The Long and Short of Portfolio Construction

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Long-Short Portfolio Construction vs. Long-Only

[By Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

Long-Short is an active portfolio construction discipline that balances long positions in high expected return securities and short positions in low expected return securities of approximately equal value and market sensitivity. This type of portfolio is “neutralized” or immunized against changes in value of the underlying market and, therefore, has zero systematic (beta) risk. If the selected securities perform as expected, the long-short positions will provide a positive return, whether the market rises or falls.

Misconceptions

While long-short portfolios are often perceived and portrayed as much costlier and much riskier than long-only, it is inherently neither. Much of the incremental cost and risk is either largely dependent on the amount of leverage employed or controllable via optimization. Those costs and risks that are not controllable—financial intermediation costs of borrowing shares to short, the trading costs incurred to meet long-short balancing, margin requirements, uptick rules, and the risks of unlimited losses on short positions—do not invalidate the viability of long-short strategies.

Long-Short Advantages

Compared with long-only portfolios, long-short portfolios offer enhanced flexibility not only in the control of risk and pursuit of return, but also in asset allocation. Basic market-neutral portfolios achieve a return consisting of three components: (1) interest on funds held as a liquidity buffer, (2) interest on the short sale proceeds maintained with the broker, and (3) the return spread between the aggregate long and aggregate short positions in the portfolios.

Disadvantages

Share borrow-ability and uptick rules make short-selling more difficult and costly than going long. Also, it may be legally or contractually restricted for some investors, such as mutual funds. Inefficiencies may be concentrated in overpriced stocks and, accordingly, short sales of the most overpriced stocks may offer higher positive returns than long purchases of underpriced stocks.

Assessment

Long-only portfolios are confined to altering the weighting of securities within an index in order to realize an excess return. Long-short portfolios are not constrained by index weights and, because they can short securities, they can “underweight” a security by as much as investment insights and risk considerations dictate. Long-short portfolios can be enhanced by “equitizing” them using stock index futures.

Note: “The Long and Short on Long-Short” by Bruce I. Jacobs and Kenneth N. Levy, The Journal of Investing, Spring 1997, pp. 73–86, Institutional Investor, Inc.

Conclusion

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Keep your Investing Options Open – Doctor

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Or – Hedge your Bets

By Dr. David Edward Marcinko MBA CMP™

http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

As a physician executive or investor, if you don’t ordinarily deal in options or other financial derivatives, you may need to brush up on puts and calls, straddles, strangles (or combinations), forwards, futures, swaps, spreads, and non-equity options such as stock index options. Options and other financial derivatives can be used by astute physicians, financial advisors and investment managers not only as a tool to better manage the investment risks potentially affecting portfolio returns, but to craft truly value-added investment strategies customized to meet investors’ needs. The three main types of risk of equity securities (individual company, industry, and market) can be mitigated with options.

Individual Company Risk

Individual company risk can be addressed with equity options in that company’s stock. Industry risk can be reduced through the use of narrow-based index options, while market risk can be mitigated with broad-based index options. Sophisticated hedging and risk management strategies can be designed using both equity and stock index options.

Exotic Stock Options?

Some doctors feel that options have been generally thought of as too risky or exotic or requiring too much capital, resulting in a general lack of comfort. A decade ago, these opinions have no doubt been shaped by the collapse of Bearings and the resulting bitter litigation by Proctor & Gamble and Gibson Greetings against Bankers Trust. More recently it has been Enron, Tyco, WorldCom, Lehman Brothers, AIG, BA, Fannie, Freddie and all those involved in the “flash-crash” of 2008-09; etc.

Assessment

Generally, premiums paid in buying puts or calls are nondeductible capital expenditures and may produce a capital gain or loss depending upon whether the option is sold prior to exercise, the call expires unexercised, or, if the option is exercised, it is added to the basis of the stock (call) or deducted from it (put). Premiums received for writing puts or calls are not included in income upon receipt but are deferred until the option expires, is exercised, or a closing transaction is entered into. Non-equity options (index options) are marked to market at year end (same as for futures) with 60% considered long-term capital gain and 40% considered short-term.

Note: “An Introduction to Options and Other Financial Derivative Strategies,” by Thomas J. Boczar, Trust & Estates, February 1997, pp. 43–68, INTERTEC/K-III Publishing.

The primary objectives in using derivatives are:

1. Risk management and hedging (reducing or eliminating downside risk, monetizing a position, deferring and possibly avoiding capital gains taxes)

2. Leveraging investment capital

3. Enhancing after-tax returns

4. Creating customized risk/return profiles

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Conclusion

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Why Classic Retirement Planning Often Fails Doctor Colleagues?

Monitor the Money – Not the Returns

Dr. David Edward Marcinko MBA CMP™

http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

While taking my certified financial planner courses to earn the CFP® designation, almost two decades ago at Oglethorpe University in Atlanta, I learned that in classic retirement planning engagements the financial planner or advisor determines the client’s retirement income needs, the assets already earmarked for the retirement portfolio, the desired retirement date, how distributions will need to be made, the assumed inflation rate, and life expectancy, etc.

Then, if a shortage develops, the advisor changes the asset allocation, increases the savings rate, proposes postponing retirement, or suggests reducing retirement income expectations, etc.

However, later in business school I learned that even when the inflation rate and investment returns prove to be accurate; this approach often fails doctors and all investors.

Geometry not Arithmetic

Why? Most planners focus on the wrong thing when monitoring portfolios. Possibly, there is confusion between compounding investment returns and compounding wealth. Planners tend to compound the arithmetical average return in projecting ending wealth over multi-period horizons. But, the accumulation of wealth is determined by the geometric compounding of actual returns.

Law of Large [Small]  Numbers

Still later on in B-school, I learned of the LoLN [normal distributions, parametric equations and cohorts], as well as Poisson distributions [non-normal or asymmetric distributions, and non-parametric equations and cohorts] or Law of Small Numbers.

Planners and Advisors often believe in the former Law of Large Numbers, and eschew [or are unaware of] the later — that is, that over time, average annual returns will approach ever more closely the expected return. The longer the investment horizon, the further the portfolio can wander from its expected dollar value despite the fact that it is approaching its expected return. The future value of each portfolio is determined by the unique and unpredictable pattern of compounded returns and inflation it suffers.

IOW: The longer the period over which this pattern can exercise its effects, the greater the potential divergence from its required return. In fact, while the expected range for the annualized rate of return narrows over time, the expected range for the terminal value of the portfolio diverges over time.

Assessment

Today, forward thinking advisors use “portfolio sufficiency monitoring” to adjust nominal performance results for inflation by establishing benchmarks for performance objectives, setting triggers for reevaluation of the portfolio when it wanders too far from established benchmarks, and monitoring and adjusting portfolio risk to maximize the probability of meeting retirement portfolio objectives.

It answers the question: “Will I have sufficient assets to meet my retirement income needs?” while investment performance monitoring answers the question, “Is my retirement portfolio performing well relative to other portfolios?” My doctor clients retire; not others!

Note: Monitoring Retirement Portfolio Sufficiency,” by Patrick J.Collins, Kristor J. Lawson, and Jon C. Chambers, Journal of Financial Planning, February 1997, pp. 66–74, Institute of Certified Financial Planners.

Conclusion

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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On the Rise and Fall of Limited Partnerships

Taking A Historical Look at this Investment Vehicle

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.com

[Publisher-in-Chief]

Back in the 1980s – a time I am loathe admitting that I remember well – limited partnerships (LPs) were all the rage and often touted as the investment vehicle of the future; especially to tax-averse physicians and high income medical professionals and investors.

Oil and gas and real estate LPs dominated the market. But, there were also cattle feeding, master recording disks, equipment and aircraft leasing, and cable TV investments. The LP heyday was 1983 through 1989, and most early LPs were private or non-publicly traded.

Popularity Rising

Why were they so popular? LPs provided the benefits of direct ownership (income potential and tax benefits) without management responsibility and personal liability. Losses were limited to one’s original investment. Brokerage firms pushed them hard, paying their sales representatives [financial advisors?] the highest commissions and often characterizing these risky investments as “safe” and a “means of capital preservation.”

Early ’80s

In the early 80s, investors could use depreciation, interest, and investment tax credits to offset not only LP income but ordinary income from salary and other investments. This was a huge incentive for high income earning doctors. In 1981, the Tax Act allowed accelerated depreciation for real estate, and non-recourse debt was treated as depreciable cost (partners bore no risk of economic loss). Soon, the IRS began to attack LPs. Both real estate and oil and gas values declined. LPs soon became illiquid investments, producing little or no return.

’86 Tax Act

Then came the Tax Reform Act of 1986 (TRA), which brought with it “at risk” limitations to real estate tax shelters and the new passive loss provisions. LP sales then spiraled downward. The ’86 Tax Law provided that limited partners could not increase their basis in the LP for their share of partnership debt unless they were personally liable for repayment or if the lender had an interest other than as a creditor (unless “qualified non-recourse debt” was used).

1990s

In the ’90s, investors either hung on to – or sold – their LP investments in the secondary market. Investors were subject to substantial discounts upon sale and they had to recapture tax benefits previously received (including those from non-recourse financing).

Assessment

Simply abandoning these investments did not avoid unfavorable tax consequences, such as the decrease in a partner’s share of partnership liabilities being treated as a cash distribution. Capital gains were recognized to the extent that a partner’s share of partnership liabilities exceeds the adjusted basis of the partner’s interest.

Note: “What Happened to Limited Partnerships?” Lee Knight and Ray Knight Journal of Accountancy, July 1997, pp. 37–42, American Institute of Certified Public Accountants.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Were you burned by LPs back in the day, or have a LP story to tell us? Please opine. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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How Doctors Divvy Up the Estate Money [New Spouse v. Kids]

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The Kids of a New Spouse

Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

Multiple marriages entail interesting estate planning moves. Why? In these days of multiple marriages, doctor clients and others often can get caught between wanting to provide for their children from a previous marriage and their spouse’s statutory inheritance rights. Depending on the state of residence, the surviving spouse may have a statutory right to a specific share of his or her spouse’s estate. But, states define what constitutes the “augmented estate” in different ways. Some fairly sophisticated estate planning may be appropriate.

States Right’s

Inasmuch as spousal rights of election were codified many decades ago when divorce was not a common occurrence, many states’ statutes do not fairly recognize the economics and family dynamics of married individuals who have children from a prior marriage. In some states, a spousal right of election is limited to those assets that pass through probate. In other states, the right of election is enforceable against not only probate assets but certain assets, such as jointly held property that would otherwise pass via title to the co-owner, gifts the decedent made within a certain time period prior to death, and life insurance benefits. This expanded pool of assets against which the right of election may be assessed is typically referred to as the “augmented estate.” Most states provide that the right of election is charged ratably against the beneficiaries under the decedent’s will and the beneficiaries of any testamentary substitutes.

The UPC

In many states, the same percentage would apply regardless of the length of the marriage. In 1990, the model Uniform Probate Code (UPC) was amended to provide a scaled right of election based on the length of the marriage. It ranges from a minimum of 12% up to a maximum of 50% for marriages of 15 years or more. Only a handful of states have adopted it. Even though the UPC includes pension and profit sharing plan benefits in the augmented estate, the sliding scale is subordinate to federal pension legislation which can result in an inequity in the case of a short-term marriage.

Assessment

While both pre- and post-nuptial agreements can help, life insurance is favored, particularly in the majority of states where it is excluded from the augmented estate. And, in states where life insurance is part of the augmented estate, it could be used to provide the surviving spouse with his or her share, particularly when a closely held business is passed on to children of a prior marriage. Financial planners, doctors and advisors need to be familiar with this area to effectively serve clients.

Note: “Providing for Children from a Prior Marriage: An Estate Planning Entry Point,” George B. Kozol, Journal of the American Society of CLU & ChFC, January 1997, pp. 52–57, American College.

Conclusion

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On FAs Working with Terminal Clients

Unique Challenges Financial Planners Face when Advising Dying Clients

By Dr. David Edward Marcinko MBBS DPM MBA MEd CMP™

http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

We doctors are comfortable – or at least familiar – in dealing with death; financial advisors and planners are not!

Although many financial planners attend conferences to keep current on sophisticated planning techniques, most are not emotionally equipped to service terminally-ill clients. Others claim that there’s intensity and an intimacy that comes with working with dying clients that can be deeply rewarding. Such clients are usually grateful for having their affairs put in order before death. The few FAs in the industry that are both physicians and advisors concur.

Myriad of Issues

The many issues that need to be addressed in these situations include:

1. How the client wants to spend their final months, what it will cost, and what impact it may have on the estate;

2. Whether to spend money [health insurance navigation] on expensive and also experimental medical treatments;

3. If there is an existing life insurance policy; the pros and cons of accelerated benefits or viatical settlements;

4. Spending down or gifting assets to reduce estate taxes;

5. How long to keep working;

6. Taking important actions while still competent to do so;

7. Deciding whether to transfer assets to the dying client (one year survival) in order to get a step-up in basis at death;

8. Helping clients decide what type of funeral or final arrangements are preferred;

9. Working with the surviving spouse to restructure final financial affairs.

Rules-of-Thumb

Financial rules of thumb are often reversed in these situations. Instead of maximizing gains, the goal is to minimize losses. Macro-planning gives way to micro-planning and crisis management. Surviving spouses may be torn between wanting to pay for treatments to save his or her spouse and to protect the funds available in the event of the spouse’s death.

Assessment

Emotional turmoil does not necessarily end with the client’s death. As the financial advisor, you may take long, tearful phone calls from a surviving spouse whose grief and anxiety has been transformed into fears about their finances. Sometimes their fear can result in irrational anger, which they may take out on you. This type of work is not for the weak-spirited.

Note: “Final Plans,” Anita J. Slomski, Dow Jones Investment Advisor, March 1997, pp. 76–82, Dow Jones Financial Publishing Corp.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. As a FA, do you work with the terminally ill? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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The Living Legacy of Dr. Harry Markowitz

Creating Diversified Portfolios of Uncorrelated Assets

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

More than a half century ago, a paper appeared in The Journal of Finance written by a 24-year-old doctoral candidate in economics at the University of Chicago—Harry Markowitz. It was called “Portfolio Selection” and suggested that investors take into account risk in pursuit of the highest return—a concept that we take for granted today [Modern Portfolio Theory].

Markowitz drew a trade-off curve between risk and reward and called it the “efficient frontier.” A rational physician executive or other investor who knew his or her risk tolerance could choose an appropriate portfolio from a point on this curve. Markowitz led investors to diversified portfolios of uncorrelated investments.

Dissertation Follow-up

Markowitz followed up his dissertation in 1959 with a book entitled Portfolio Selection [Efficient Diversification of Investment]. His many contributions to finance earned him the Nobel Prize in Economic Science in 1990 along with William Sharpe and Merton Miller. He reasoned that diversification is about avoiding the covariance.

If risks are uncorrelated, you can reduce the risk of a portfolio to practically zero by sufficient diversification. This doesn’t work if risks are correlated. If one invests in a very large number of securities that are correlated, risk does not approach zero but rather the average covariance, which is a very substantial amount of risk.

Where It All Started

It was at the RAND Corporation that Markowitz met William [Bill] Sharpe who was working on his PhD at UCLA. Markowitz takes issue with Sharpe’s Capital Asset Pricing Model (CAPM), which claims that the expected return of a security depends only on its beta—ignoring fundamental analysis.

CAPM also implies that the market portfolio is efficient, even though investors in the market may not act rationally. It says that the market portfolio is a mean-variance efficient portfolio. Markowitz disputes this conclusion. He points to Fama and French and others who have found that expected returns are more closely related to book-to-price or size—not to beta.

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Assessment

The still living Markowitz fends off criticism of mean-variance analysis only being valid when probability distributions are normal by stating that he realizes that probability distributions are not normal in the real world.

But, if they are similar to a normal distribution, mean variance does a good job at approximating expected utility. He admits that when they are too dispersed, mean variance doesn’t work well.

Note: Travels along the Efficient Frontier,” an interview with Harry Markowitz by Jonathan Burton, Dow Jones Asset Management, May/June 1997, pp. 21–28, Dow Jones Financial Publishing Corp.

Conclusion

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