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David Cummings on Startups

Back in college I’d routinely jump in my old Jeep Wrangler and make the 10 mile drive down the Durham Freeway to RTP for events and programs at the Council for Entrepreneurial Development (CED). CED bills itself as “the network that helps Triangle entrepreneurs build successful companies” and has 700+ member companies with 4,000 members. In Atlanta, we have a number of strong entrepreneurial non-profits:

Only, we don’t have a central entrepreneur organization that encompasses both tech and non-tech startups. As expected, there are a tremendous number of non-tech entrepreneurs in town. EO has a strong Atlanta chapter with over 100 members, but that’s limited to companies with at least $1 million in revenue. Where do non-tech entrepreneurs go?

Last week I had the chance to learn…

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NEW REPORT HIGHLIGHTS DELAYED DIAGNOSIS AND CAREGIVER BURDEN IN LEWY BODY DEMENTIAS

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Nearly 80% of people with Lewy body dementias (LBD) received a diagnosis for a different cognitive, movement or psychiatric disorder before ultimately learning they had LBD, according to the Lewy Body Dementia Association’s Caregiver Burden in Lewy Body Dementias, released recently.

This new report reveals people with LBD and their caregivers face barriers to obtaining an early LBD diagnosis. Caregivers rate specialists and general practitioners as inadequate in discussing disease progression. Additionally, caregivers experience moderate to severe emotional burden, and most experience a sense of isolation because so few people know about LBD.

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ST19

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NEW REPORT HIGHLIGHTS DELAYED DIAGNOSIS AND CAREGIVER BURDEN IN LEWY BODY DEMENTIAS

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Physician-executives during options trade discussion!

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How [Physician] Investors Should Deal With The Overwhelming Problem Of Understanding The World Economy

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“What the —- do I do now?”

By Vitaliy N. Katsenelson CFA

vitaly This was the actual subject line of an e-mail I received that really summed up most of the correspondence I got in response to an article I published recently. To be fair, I painted a fairly negative macro picture of the world, throwing around a lot of fancy words, like “fragile” and “constrained system.” I guess I finally figured out the three keys to successful storytelling: One, never say more than is necessary; two, leave the audience wanting more; and three … Well, never mind No. 3, but here is more.

Domestic / Global Economy

Before I go further, if you believe the global economy is doing great and stocks are cheap, stop reading now; this column is not for you. I promise to write one for you at some point when stocks are cheap and the global economy is breathing well on its own — I just don’t know when that will be. But if you believe that stocks are expensive — even after the recent sell-off — and that a global economic time bomb is ticking because of unprecedented intervention by governments and central banks, then keep reading.

Today, after the stock market has gone straight up for five years, investors are faced with two extremes: Go into cash and wait for the market crash or a correction and then go all in at the bottom, or else ride this bull with both feet in the stirrups, but try to jump off before it rolls over on you, no matter how quickly that happens.

Of course, both options are really nonoptions. Tops and bottoms are only obvious in the rearview mirror. You may feel you can time the market, but I honestly don’t know anyone who has done it more than once and turned it into a process.

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sad

[INSANITY]

Psychology

Those little gears spinning but not quite meshing in your so-called mind — will drive you insane. It is incredibly difficult to sit on cash while everyone around you is making money. After all, no one knows how much energy this steroid-maddened bull has left in him. This is not a naturally raised farm animal but a by-product of a Frankenstein-like experiment by the Fed. This cyclical market (note: not secular; short-term, not long-term) may end tomorrow or in five years. Riding this bull is difficult because if you believe the market is overvalued and if you own a lot of overpriced stocks, then you are just hoping that greater fools will keep hopping on the bull, driving stock prices higher. More important, you have to believe that you are smarter than the other fools and will be able to hop off before them (very few manage this). Good luck with that — after all, the one looking for a greater fool will eventually find that fool by looking in the mirror.

As I wrote in an article last spring, “As an investor you want to pay serious attention to ‘climate change’ — significant shifts in the global economy that can impact your portfolio.” There are plenty of climate-changing risks around us — starting with the prospect of higher, maybe even much higher, interest rates — which might be triggered in any number of ways: the Fed withdrawing quantitative easing, the Fed losing control of interest rates and seeing them rise without its permission, Japanese debt blowing up. Then we have the mother of all bubbles: the Chinese overconsumption of natural and financial resources bubble.

Of course, Europe is relatively calm right now, but its structural problems are far from fixed. One way or another, the confluence of these factors will likely lead to slower economic growth and lower stock prices. So “what the —-” is our strategy? Read on to find out. I’ll explain what we’re doing with our portfolio, but first let me tell you a story.

My Story

When I was a sophomore in college, I was taking five or six classes and had a full-time job and a full-time (more like overtime) girlfriend. I was approaching finals, I had to study for lots of tests and turn in assignments, and to make matters worse, I had procrastinated until the last minute. I felt overwhelmed and paralyzed. I whined to my father about my predicament. His answer was simple: Break up my big problems into smaller ones and then figure out how to tackle each of those separately. It worked. I listed every assignment and exam, prioritizing them by due date and importance. Suddenly, my problems, which together looked insurmountable, one by one started to look conquerable. I endured a few sleepless nights, but I turned in every assignment, studied for every test and got decent grades.

[Physician] investors need to break up the seemingly overwhelming problem of understanding the global economy and markets into a series of small ones, and that is exactly what we do with our research. The appreciation or depreciation of any stock (or stock market) can be explained mathematically by two variables: earnings and price-earnings ratio. We take all the financial-climate-changing risks — rising interest rates, Japanese debt, the Chinese bubble, European structural problems — and analyze the impact they have on the Es and P/Es of every stock in our portfolio and any candidate we are considering. Let me walk you through some practical applications of how we tackle climate-changing risks at my firm.

When China eventually blows up, companies that have exposure to hard commodities, directly or indirectly (think Caterpillar), will see their sales, margins and earnings severely impaired. Their P/Es will deflate as well, as the commodity supercycle that started in the early 2000s comes to an end. Countries that export a lot of hard commodities to China will feel the aftershock of the Chinese bubble bursting. The obvious ones are the ABCs: Australia, Brazil and Canada.

However, if China takes oil prices down with it, then Russia and the Middle East petroleum-exporting mono-economies that have little to offer but oil will suffer. Local and foreign banks that have exposure to those countries and companies that derive significant profits from those markets will likely see their earnings pressured. (German automakers that sell lots of cars to China are a good example.) Japan is the most indebted first-world nation, but it borrows at rates that would make you think it was the least indebted country. As this party ends, we’ll probably see skyrocketing interest rates in Japan, a depreciating yen, significant Japanese inflation and, most likely, higher interest rates globally. Japan may end up being a wake-up call for debt investors. The depreciating yen will further stress the Japan-China relationship as it undermines the Chinese low-cost advantage.

So paradoxically, on top of inflation, Japan brings a risk of deflation as well. If you own companies that make trinkets, their earnings will be under assault. Fixed-income investors running from Japanese bonds may find a temporary refuge in U.S. paper (driving our yields lower, at least at first) and in U.S. stocks. But it is hard to look at the future and not bet on significantly higher inflation and rising interest rates down the road.

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confirmation-bias

[Inflation / Deflation Paradox]

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A Side Note

Economic instability will likely lead to political instability. We are already seeing some manifestations of this in Russia. Waltzing into Ukraine is Vladimir Putin’s way of redirecting attention from the gradually faltering Russian economy to another shiny object — Ukraine. Just imagine how stable Russia and the Middle East will be if the recent decline in oil prices continues much further. Defense industry stocks may prove to be a good hedge against future global economic weakness. Inflation and higher interest rates are two different risks, but both cause eventual deflation of P/Es. The impact on high-P/E stocks will be the most pronounced.

I am generalizing, but high-P/E growth stocks are trading on expectations of future earnings that are years and years away. Those future earnings brought to the present (discounted) are a lot more valuable in a near-zero interest rate environment than when interest rates are high. Think of high-P/E stocks as long-duration bonds: They get slaughtered when interest rates rise (yes, long-term bonds are not a place to be either). If you are paying for growth, you want to be really sure it comes, because that earnings growth will have to overcome eventual P/E compression. Higher interest rates will have a significant linear impact on stocks that became bond substitutes. High-quality stocks that were bought indiscriminately for their dividend yield will go through substantial P/E compression.

These stocks are purchased today out of desperation. Desperate people are not rational, and the herd mentality runs away with itself. When the herd heads for the exits, you don’t want to be standing in the doorway. Real estate investment trusts (REITs) and master limited partnerships (MLPs) have a double-linear relationship with interest rates: Their P/Es were inflated because of an insatiable thirst for yield, and their earnings were inflated by low borrowing costs. These companies’ balance sheets consume a lot of debt, and though many of them were able to lock in low borrowing costs for a while, they can’t do so forever. Their earnings will be at risk.

As I write this, I keep thinking about Berkshire Hathaway vice chairman Charlie Munger’s remark at the company’s annual meeting in 2014, commenting on the then-current state of the global economy: “If you’re not confused, you don’t understand things very well.” A year later the state of the world is no clearer. This confusion Munger talked about means that we have very little clarity about the future and that as an investor you should position your portfolio for very different future economies. Inflation? Deflation? Maybe both? Or maybe deflation first and inflation second? I keep coming back to Japan because it is further along in this experiment than the rest of the world.

The Japanese real estate bubble burst, the government leveraged up as the corporate sector deleveraged, interest rates fell to near zero, and the economy stagnated for two decades. Now debt servicing requires a quarter of Japan’s tax receipts, while its interest rates are likely a small fraction of what they are going to be in the future; thus Japan is on the brink of massive inflation. The U.S. could be on a similar trajectory. Let me explain why. Government deleveraging follows one of three paths. The most blatant option is outright default, but because the U.S. borrows in its own currency, that will never happen here. (However, in Europe, where individual countries gave the keys to the printing press to the collective, the answer is less clear.) The second choice, austerity, is destimulating and deflationary to the economy in the short run and is unlikely to happen to any significant degree because cost-cutting will cost politicians their jobs.

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Japan and world markets tumbling - dollar stronger

[Nikkei Index]

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Last, we have the only true weapon government can and will use to deleverage: printing money. Money printing cheapens a currency — in other words, it brings on inflation. In case of either inflation or deflation, you want to own companies that have pricing power — it will protect their earnings. Those companies will be able to pass higher costs to their customers during a time of inflation and maintain their prices during deflation. On the one hand, inflation benefits companies with leveraged balance sheets because they’ll be paying off debt with inflated (cheaper) dollars.

IRs

However, that benefit is offset by the likely higher interest rates these companies will have to pay on newly issued debt. Leverage is extremely dangerous during deflation because debt creates another fixed cost. Costs don’t shrink as fast as nominal revenues, so earnings decline. Therefore, unless your crystal ball is very clear and you have 100 percent certainty that inflation lies ahead, I’d err on the side of owning underleveraged companies rather than ones with significant debt. A lot of growth that happened since 2000 has taken place at the expense of government balance sheets. It is borrowed, unsustainable growth that will have to be repaid through higher interest rates and rising tax rates, which in turn will work as growth decelerators. This will have several consequences:

First, it’s another reason for P/Es to shrink. Second, a lot of companies that are making their forecasts with normal GDP growth as the base for their revenue and earnings projections will likely be disappointed. And last, investors will need to look for companies whose revenues march to their own drummers and are not significantly linked to the health of the global or local economy. The definition of “dogma” by irrefutable Wikipedia is “a principle or set of principles laid down by an authority as incontrovertibly true.” On the surface this is the most dogmatic columns I have ever written, but that was not my intention. I just laid out an analytical framework, a checklist against which we stress test stocks in our portfolio. Despite my speaking ill of MLPs, we own an MLP. But unlike its comrades, it has a sustainable yield north of 10 percent and, more important, very little debt. Even if economic growth slows down or interest rates go up, the stock will still be undervalued — in other words, it has a significant margin of safety even if the future is less pleasant than the present.

There are five final bits of advice I want to leave you

First, step out of your comfort zone and expand your fishing pool to include companies outside the U.S. That will allow you to increase the quality of your portfolio without sacrificing growth characteristics or valuation. It will also provide currency diversification as an added bonus.

Second, disintermediate your buy and sell decisions. The difficulty of investing in an expensive market that is making new highs is that you’ll be selling stocks that hit your price targets. (If you don’t, you should.) Of course, selling stocks comes with a gift — cash. As this gift keeps on giving, your cash balance starts building up and creates pressure to buy. As parents tell their teenage kids, you don’t want to be pressured into decisions. In an overvalued market you don’t want to be pressured to buy; if you do, you’ll be making compromises and end up owning stocks that you’ll eventually regret.

Assessment

Margin of safety, margin of safety, margin of safety — those are my last three bits of advice. In an environment in which the future of Es and P/Es is uncertain, you want to cure some of that uncertainty by demanding an extra margin of safety from stocks in your portfolio.

ABOUT

Vitaliy N. Katsenelson CFA is Chief Investment Officer at Investment Management Associates in Denver, Colo. He is the author of Active Value Investing (Wiley 2007) and The Little Book of Sideways Markets (Wiley, 2010).  His books were translated into eight languages.  Forbes Magazine called him “The new Benjamin Graham”.  

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Tools for Navigating the Market Pullback

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By Lon Jefferies CFP MBA lon@networthadvice.com | http://www.networthadvice.com 

Lon JefferiesOn August 24th 2015, the Dow Jones Industrial Average opened the day decreasing in value by more than 1,000 points, equating to a -6.42% decline. One of the most volatile days in memory continued, with the DOW fighting back to nearly even by mid-day, down only 98 points or about -0.60%.

Unfortunately, the bounce couldn’t be maintained through the market close with the DOW ending the day down 588 points, off about -3.6%.

How are investors to deal with this level of uncertainty?

First and foremost, remember that this is what diversification is for. It is easy to look at a major market index like the DOW or the S&P 500 and equate the performance of those assets to the performance of your portfolio. However, the first thing investors should remind themselves is that they don’t have a portfolio consisting of only large cap stocks, which is what is measured by both the DOW and S&P 500 index.

In fact, most investors don’t have a portfolio consisting of just stocks. Many investors who are nearing or enjoying retirement may have a portfolio that is closer to only 50% or 60% stocks. If an investor only has 50% of his portfolio invested in stocks, only 50% of the portfolio is invested in the asset that declined in value by -3.6% on August 24th, meaning the individual’s portfolio likely only decreased by about -1.80%. While a -1.80% decline is not pleasant, it is hardly catastrophic.

The next step is to remind ourselves that temporary sharp market declines are common. Morgan Housel, one of my favorite financial writers, noticed that the correction the market is currently experiencing is still not nearly as bad as the correction that took place in the summer of 2011 when the DOW lost 2,000 points in 14 days (a loss of about -15.5%). Mr. Housel points out that no one now remembers or cares about that short-term correction. These market pullbacks will always come and go, and the world will continue to turn.

Additionally, it is useful to acknowledge that while we tend to remember dramatic and shocking market decreases, stocks tends to be an efficient investment over time. Another one of my favorite financial journalists, Ben Carlson, pointed out in his blog that when investors think of the ‘80s the first thing that comes to mind is usually the Crash of ’87 when the Dow lost -22% in one day (Black Monday). However, U.S. stocks were up over 400% during the decade. Similarly, even though stocks are up 200% since March of 2009, many investors have spent the last five years trying to anticipate the next 10% – 20% correction. In retrospect, an investor would have clearly been better off riding the equities rollercoaster during both the good and bad times and ending with a 200% gain rather than being out of the market in an attempt to avoid a small temporary decline. Given a long enough investment time frame, this has always been true and I believe this will continue to be the case.

Finally, as I pointed out in a previous article, it is useful to recall that market corrections are actually a good thing for long-term investors. Fear among investors is what creates the equity risk premium that enables stocks to produce superior investment results when compared to investments with no risk such as CDs and money markets, which essentially experience no growth after accounting for inflation. When investors forget that equities can go both up and down in value, everyone wants to invest their money in stocks. This excess demand inflates asset purchase prices to the point that owning equities is no longer profitable. Market declines reintroduce risk to the investing public, and it is the presence of risk that makes stocks an appreciating asset. Thus, for those who don’t intend to sell their investments for 10+ years, short periods of volatility are a positive because they recreate the equity risk premium which raises rates of return over time.

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Bear + A Falling Stock Chart

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Logical steps

These are all logical steps for mentally dealing with market corrections. For those who need it, Josh Brown from CBNC proposes a less logical step for tricking your mind into embracing the market pullback. During scary market environments, Mr. Brown proposes that you identify a couple of stocks you’ve always felt you missed out on. Have you always wished you got in earlier on Apple, Google, Netflix, Chipotle, etc? A market correction like we are experiencing might be the perfect opportunity to become an owner of a great stock at an attractive price. Why not set a number for each of these stocks – say, if they drop in value by 20% – and if those targets are met you commit to buying some shares?

This strategy truly enables you to use lemons to make lemonade. It provides an opportunity to buy shares of companies that you have always wanted without overpaying for them. This mental trick can actually cause you to hope that the market correction continues because you are now hoping for a chance to buy. Rooting for a further correction can certainly make volatile market periods more tolerable.

As I mentioned, this mentality isn’t completely logical because the rest of your portfolio will likely need to decline in value in order to afford you the opportunity to purchase those coveted stocks. However, implementing this strategy is a bit of a mental hedge that enables you to get something good out of whichever direction the market turns. Think of promising yourself a fancy dinner if your favorite sports team loses – of course you don’t want your team to lose, but even if they do you still get something positive out of it.

Assessment

I’m confident that most of my clients already know that selling in the middle of a market correction is not a good idea. Still, I acknowledge that doing nothing as the market seems to be collapsing around you can be nerve-racking – even though it has historically been an appropriate response. Hopefully these mental strategies and tricks enable you to stick to your long-term buy-and-hold investment strategy which has always proved to be profitable given a long enough time frame.

NOTE:

–On a side note, I had zero clients call or email expressing a desire to sell positions yesterday. This enabled everyone to participate in today’s market bounce. Smart clients rule. 

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Stress Testing your Investment Portfolio

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What is Your Risk Number?

DG

[By David Gratke]

Are your current investments aligned with YOUR investment goals and expectations?

As we all know, the global financial markets have responded tremendously to the past seven years of Global Central Bank monetary polices. i.e. asset prices, stocks, bonds and real estate have all gone up in price as a result. When have you ‘stress-tested’ your portfolio to see how durable it may through various market cycles?

How do you determine if your current investment holdings are right for you. Maybe they are too conservative, or just the opposite, too aggressive?  Maybe they are right where they need to be, but how do you know, how do you measure that?

  • Capture you Risk Tolerance
  • See if your portfolio fits you.
  • Ok, How do I Start?

By simply answering a few questions, and spending 10 minutes of your time, based upon the size of your investment portfolio, you will quickly determine your own tolerance for risk.

Comparing your Risk Number to your Portfolio

Now that you have calculated your Risk Number, how does that number compare to your actual portfolio holdings? Is the portfolio you have today, the one you started with some time ago regarding risk and return? Is it still in alignment with your original expectations?

Does your portfolio have?

  • Too much risk?
  • Is it too conservative?
  • Or, is it just right
  • What if the market drops significantly? Instead, what if the market goes up significantly? See how your current portfolio will fair in any one of these market conditions:
  • Let’s put your portfolio onto the treadmill; just like the doctor’s office.
  • How do you know, how do you measure?

Let’s Stress Test your Portfolio

  1. Bull Market (Prices generally rise)
  2. Bear Market (Prices generally fall)
  3. Financial Crisis
  4. Rising Interest Rates

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ScreenShot2015-06-01at11_34_02AM_113439

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  • Are the results in alignment with your expectations?
  • Any ‘hot spots’ you need to know about?
  • Are there any individual holdings that will cause you loss of sleep over?
  • Maybe investments don’t generate enough income?
  • Maybe investments fluctuate too much in price?
  • Now you can have a look and see if there are any ‘hot spots’ where you may need to re-balance a portion of your holdings based upon these findings.

***

2

Yes! That feels like me

***

Congratulations. Once you have determined your Risk Number, and perhaps re-aligned your current portfolio to your Risk Number, then yes, you DO have the portfolio that is right for you, one that ‘feels like you’. What is Your Risk Score?

ABOUT

David Gratke is chief executive officer of Gratke Wealth LLC in Beaverton, Ore. A Registered Investment Advisory Firm.

***

Conclusion

Your thoughts and comments on this ME-P are appreciated. How does the current market tumult affect this ME-P or your own investing strategy? 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.

***

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™

“Physicians who don’t understand modern risk management, insurance, business and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners. This comprehensive volume from Dr. David Marcinko, and his co-authors, will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.”

Dr. James M. Dahle MD FACEP [Editor of The White Coat Investor, Salt Lake City, Utah]

***

USA “With time at a premium, and so much vital information packed into one well organized resource, this comprehensive textbook should be on the desk of everyone serving in the healthcare ecosystem. The time you spend reading this frank and compelling book will be richly rewarded.”

Dr. J. Wesley Boyd MD PhD MA [Harvard Medical School, Boston, Massachusetts, USA]

Five facts about the world’s largest pension funds

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An Infographic 

[By Towers Watson]

The Pensions & Investments / Towers Watson 300 infographic illustrates the top five facts arising from the joint research of the largest global pension funds in 2013.

*** pension-funds

 ***

Editor’s Note:

The healthcare industry relevance of this info-graphic lies in these back-of-envelope statistics for traditional hospital, health pension and related 403[b] retirement plans, as follows:

  • $15-Trillion pension plan investment, worldwide.
  • USA representing 40% of the above for about $6 trillion.
  • Now, as healthcare represents about 20% domestic GDP = $1.2 trillion.  

Assessment

So, can you now appreciate the massive amount of potential fees [range 1-8%] generated by Wall Street investment bankers and fund management gurus?

More: Pension funds linger, even make comeback, among healthcare providers

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:

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

Front Matter with Foreword by Jason Dyken MD MBA

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Mid-Year 2015 Un-Insured Rates

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Health Insurance by US State

By http://www.MCOL.com

ImageProxy

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:

[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

Product DetailsProduct Details

***

Do RetroSpective Thoughts on Apple Inc Hint of the ProSpective Future after the “Crash” Today?

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PART I.

Understanding Apple Requires an Analysis of Fundamentals and Psychology

vitalyBy Vitaliy Katsenelson CFA

So many articles have been written recently about Apple — defending it or explaining why this glorious fruit will turn into a shriveling pumpkin by midnight (with Samsung’s help) — that I really haven’t felt the need to contribute to the unending debate.

But, when Apple’s stock crashed to $450 back in January 2013, we bought a little for our clients. After receiving an outraged e-mail from one of them calling the purchase “irresponsible” and proclaiming that everyone (including his neighbor) knows that Apple is going down to $300, I decided it was time to join the discourse. Clients rarely (almost never) contact us about stocks we own in their accounts. More important, this is far from the most “radioactive” stock we own or have owned.

So, here is a column on Apple, I wrote back then.  I have no intention of defending or prosecuting the company, but I would like to share some thoughts about it that many pundits have either overlooked or ignored.

***

Logo of Apple Inc. to be used on a custom landing page/brand page about Apple products on the website of Shopping.com.

***

The Psychlogy

What makes Apple stock difficult to own is psychology. The company’s success since 2000 is a black swan. We tend to think of Nassim Nicholas Taleb’s black swans as significant random negative events, but Apple is a positive one. When co-founder Steve Jobs came back to the company in the late ’90s, Apple was about to take its last breath. Jobs pulled off a miracle. He revived the company’s computer product line, making Macs exciting again, and then came out with three revolutionary “i” products in a row: the iPod, iPhone and iPad. You could argue that the success of each “i” product in itself was a black swan, exceeding all rational expectations and revolutionizing, transforming and in some cases creating new categories of merchandise that had never existed before.

Revenue and Market Capitalization

Apple’s revenue and market capitalization deservedly surpassed those of almighty Microsoft Corp. — the hairy monster with stinky breath that performed CPR on dying Apple in the late ’90s by injecting liquidity into the company by buying its preferred stock. We have a hard time processing this highly improbable success and an even harder time imagining that there is another black swan about to take flight from the Apple labs, especially with no Steve Jobs around to sit on the egg.

Black swans come out of nowhere, unannounced, but their impact may be long-lasting. The wildly successful “i” gadgets dug a formidable moat around Apple. They created the most valuable and still most inspirational brand in the world, funded an enormous research and development effort, enabled huge buying power (Apple locks up supply and pays much lower prices than many of its competitors for parts), filled out a mature product ecosystem and stuffed Apple’s debt-free balance sheet with $137 billion — half the market capitalization of Microsoft. The moat is wide, deep and unlikely to be breached any time soon.

***

Ex-Cathedra black swan

***

High Price

One reason the psychology of owning Apple stock is so difficult: it’s high price. (Note: I am talking not about its valuation but purely about its price.) Apple has had only one stock split since the late ’90s, when it was trading in double digits, and it now changes hands at about $450 (down from $700 just a few months ago). Stock splits create zero economic value in the long run — absolutely none. Apple could split its stock ten to one and you’d have ten $45 shares, and nothing about the company or its business would change. But, I’d argue that a 3 percent “slide” of $1.35 would grab fewer headlines than a $13.50 “drop” — there is a media magnification factor that is hard to ignore.

Hardware versus Software

Is Apple a hardware or a software company? This is a very important question because Apple’s net margins of 25 percent are dangerously higher than those of Microsoft, a software monopoly that, with the minor exception of the Xbox and its new venture into tablets, sells only software, which has a 100 percent incremental margin.

Apple is either a smart hardware company or a software maker dressed in hardware company clothes. Take a look at the PC businesses of traditional “dumb” hardware companies like Dell and Hewlett-Packard Co. (I am not insulting these companies, I am just highlighting their lack of PC-directed R&D.) They buy hard drives from Western Digital Corp., graphic cards from Nvidia Corp., processors from Intel Corp. and an operating system from Microsoft, then they have contract manufacturers put together these parts in Asia and ship PCs all over the world. Dell and HP engineers design the PCs but contribute minimal R&D to their boxes; most of the R&D is done by the suppliers. Dell and HP are really asset-lite marketing and logistics companies — this explains their razor-thin margins. (Side note: Because of a lack of fixed costs, Dell and HP can remain profitable despite the ongoing decline in PC sales.)

Same Surface

On the surface, Apple’s personal computer business is not that much different from Dell’s or HP’s: It uses the same highly commoditized hardware and it also outsources manufacturing, but Apple spends much more on the R&D of its own operating system and creates distinctive, innovative products. Apple gets to keep a slice of revenue that would otherwise go to Microsoft for the operating system. Also, Apple is able to charge a premium (usually a few hundred dollars per PC) for the aesthetic appeal and perceived ease of use of its products.

However, when it comes to the “i” devices, Apple is a much smarter hardware company; its value added goes further than just basic design and software. Though there is a lot of commoditized hardware that goes into an iPhone or iPad, Apple’s skill at fitting an ever-growing number of components into ever-shrinking devices constantly increases. Add world-class touch and feel, superior battery life and durability, and you have a package that turns what would otherwise be commodity items into highly differentiated, and undeniably sexy, products. Apple has even gone a step further and is designing its own microprocessors.

But — and this is a very important “but” — as phones and tablets mature, processor speed, battery life and weight will tend to become uniform across all devices. It is arguable that the competition has already caught up with Apple in the hardware race. As the hardware premium goes away, there will be only two premiums left: Apple’s brand and its ecosystem. (I will go into detail about the “i” ecosystem and what it means for Apple’s margins and profitability in my second essay posted below).

Note that I did not mention the software premium. Unlike Microsoft, which charges for the Windows operating system installed on PCs, Google gives away Android to anyone who dares to make a phone or a tablet. Unless Apple can maintain the operating system lead against Android, that premium will go away.

Assessment

Recently, I spent a few days playing with Nexus 7, Google’s Android-powered 7-inch tablet, which retails for $200 ($130 cheaper than Apple’s iPad mini). Nexus 7 is a good product, but I kept remembering that humans and monkeys share 98 percent of their DNA, and the Android operating system is missing the 2 percent that makes Apple iOS so special.

*** 

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PART II.

How Much Would You Pay for the Apple Ecosystem?

Apple’s ecosystem is an important and durable competitive advantage; it creates a tangible switching cost (or, an inconvenience) after Apple has locked you into the i-ecosystem. It takes time to build an ecosystem that consists of speakers and accessories that will connect only via Apple systems: Apple TV, which easily recreates an iPhone or iPad screen on a TV set; the music collection on iTunes (competition from Spotify and Google Play lessens this advantage); a multitude of great apps (in all honesty, gaming apps have a half-life of only a few weeks, but productivity apps and my $60 TomTom GPS have a much longer half-life); and, last, the underrated Photo Stream, a feature in iOS 6 that allows you to share photos with your close friends and relatives with incredible ease. My family and friends share pictures from our daily lives (kids growing up, ski trips, get-togethers), but that, of course, only works when we’re all on Apple products. (This is why Facebook bought Instagram for $1 billion. Photo Stream is a real competitive threat to Facebook, especially if you want to share pictures with a limited group of close friends.)

The i-ecosystem makes switching from the iPhone to a competitor’s device an unpleasant undertaking, something you won’t do unless you are really significantly dissatisfied with your i-device (or you are simply very bored). How much extra are you willing to pay for your Apple goodies? Brand is more than just prestige; it is the amalgamation of intangible things like perceptions and tangible things like getting incredible phone and e-mail customer service (I’ve been blown away by how great it is!) or having your problems resolved by a genius at the Apple store.

Of course, as the phone and tablet categories mature, Apple’s hardware premium will deflate and its margins will decline. The only question is, by how much?

Let me try to answer

From 2003 to 2012, Apple’s net margins rose from 1.1 percent to 25 percent. In 2003 they were too low; today they are too high. Let’s look at why the margins went up. Gross margins increased from 27.5 percent to 44 percent: Apple is making 16.5 cents more for every dollar of product sold today than it did in 2001. Looking back at Nokia Corp. in its heyday, in 2003 the Finnish cell phone maker was able to command a 41.5 percent margin, which has gradually drifted down to 28 percent.

Today, Nokia is Microsoft’s bitch, completely dependent on the success of the Windows operating system, which is far from certain. Nokia is a sorry shell of what used to be a great company, while Apple, despite its universal hatred by growth managers, is still, well, Apple. Its gross margins will decline, but they won’t approach those of 2003 or Nokia’s current level.

For Apple to conquer emerging markets and keep what it has already won there, it will need to lower prices. The company is not doing horribly in China — its sales are running at $25 billion a year and were up 67 percent in the past quarter.

However, a significant number of the iPhones sold in China (Apple doesn’t disclose the figure) are not $650 iPhone 5’s but the cheaper 4 and 4s models. (Also, on a recent conference call, Verizon Communications mentioned that half of the iPhones it has sold were the 4 and 4s models.) Apple’s price premium over its Android brethren is not as high as everyone thinks.

What is truly astonishing is that Apple’s spending on R&D and selling, general and administrative (SG&A) expenses has fallen from 7.6 percent and 19.5 percent, respectively, in 2003 to a meager 2.2 percent and 6.4 percent today. R&D and SG&A expenses actually increased almost eightfold, but they didn’t grow nearly as fast as sales. Apple spends $3.4 billion on R&D today, compared with $471 million in 2001. This is operational leverage at its best. As long as Apple can grow sales, and R&D and SG&A increase at the same rate as sales or slower, Apple should keep its 18.5 percentage points gain in net margins through operational leverage.

***

***

Growth of sales is an assumption in itself. Apple’s annual sales are approaching $180 billion, and it is only a question of when they will run into the wall of large numbers. At this point, 20 percent-a-year growth means Apple has to sell as many i-thingies as it sold last year plus an additional $36 billion worth. Of course, this argument could have been made $100 billion ago, and the company did report 18 percent revenue growth for the past quarter, but Apple is in the last few innings of this high-growth game; otherwise its sales will exceed the GDP of some large European countries.

If you treat Apple as a pure hardware company, you’ll miss a very important element of its business model: recurrence of revenues through planned obsolescence. Apple releases a new device and a new operating system version every year. Its operating system only supports the past three or four generations of devices and limits functionality on some older devices. If you own an iPhone 3G, iOS 6 will not run on it, and thus a lot of apps will not work on it, so you will most likely be buying a new iPhone soon. In addition — and not unlike in the PC world — newer software usually requires more powerful hardware; the new software just doesn’t run fast enough on old phones. My son got a hand-me-down iPhone 3G but gave it to his cousin a few days later — it could barely run the new software.

As I wrote above, Apple’s success over the past decade is a black swan, an improbable but significant event, thanks in large part to the genius of Steve Jobs. Today investors are worried because Jobs is not there to create another revolutionary product, and they are right to be concerned. Jobs was more important to Apple’s success than Warren Buffett is to Berkshire Hathaway’s today. (Berkshire doesn’t need to innovate; it is a collection of dozens of autonomous companies run by competent managers.) Apple will be dead without continued innovation.

Jobs was the ultimate benevolent dictator, and he was the definition of a micro-manager. In his book Steve Jobs, Walter Isaacson describes how Jobs picked shades of white for Apple Store bathroom tiles and worked on the design of the iPhone box. He had to sign off on every product Apple made, down to and including the iPhone charger. His employees feared, loved and worshiped him, and they followed him into the fire. Jobs could change the direction of the company on a dime — that was what it took to deliver black i-swans. Jobs is gone, so the probability of another product achieving the success of the iPhone or iPad has declined exponentially.

***

Steve Jobs RIP

***

What is really amazing about Apple is how underwhelming its valuation is today — it doesn’t require new black swans.

In an analysis we tried very hard to kill the company. We tanked its gross margins to a Nokia-like 28 percent and still got $30 of earnings per share (the Street’s estimate for 2013 is $45), which puts its valuation, excluding $145 a share in cash, at 10 times earnings. We killed its sales growth to 2 percent a year for ten years, discounted its cash flows and still got a $500 stock.

There is a lot of value in Apple’s enormous ability to generate cash. The company is sitting on an ever-growing pile of it — $137 billion, about one third of its market cap. Over the past 12 months, despite spending $10 billion on capital expenditures, Apple still generated $46 billion of free cash flows. If it continues to generate free cash flows at a similar rate (I am assuming no growth), by the end of 2015 it will have stockpiled $300 of cash per share. At today’s price [2013] it will be commanding a price-earnings ratio (if you exclude cash) of 4.

Of course, the market is not giving Apple credit for its cash, but I think the market is wrong. Unlike Microsoft, which does something dumber than dumb with its cash every other year, Apple has a pristine capital allocation track record. It has not made any foolish acquisitions — or, indeed, any acquisitions of size. Other than buying an Eastern European country and renaming it i-Country, Apple will not be able to acquire a technologically related company of size, nor will it want or need to. The cash it accumulates will end up in shareholders’ hands, either through dividends or share buybacks.

What is Apple worth?

After the financial acrobatics I’ve done trying to murder the valuation of Apple, it is easier to say that it is worth more than $450 than to pinpoint a price target. When I use a significantly decelerating sales growth rate and normalize margins (reducing them, but not as low as Nokia’s current margins), I get a price of about $600 to $800 a share.

Growth managers don’t want Apple to pay a large dividend, as though that would somehow transform this growing teenager into a mature adult. But I have news for them: Apple already is a mature adult. Second, when your return on capital is pushing infinity (as Apple’s is), you don’t need to retain much cash to grow. Two thirds of Apple’s cash is offshore, but that doesn’t make it worthless; it just makes it worth less — only $65 billion, maybe, not $97 billion, once the company pays its tax bill to Uncle Sam.

***

ImageProxy

***

Assessment

In the short term none of the things I am writing about here will matter. Remember, “Everyone knows Apple is going to $300,” as a client recently e-mailed me, as everyone knew it was going to a $1,000 a few months ago when Apple’s stock was trading at $700. The company’s stock will trade on emotion, fundamentals will not matter, and growth managers will likely rotate out of Apple, because once the stock declined from $700 to $450, the label on it changed from “growth” to “value.”

But ultimately, fundamentals will prevail. Like the laws of physics, they can only be suspended for so long. And so, do these retrospective thoughts on Apple hint of future prospects?

More: Should You Buy Apple Stock Ahead of Its September Event

ABOUT

Vitaliy N. Katsenelson CFA is Chief Investment Officer at Investment Management Associates in Denver, Colo. He is the author of Active Value Investing (Wiley 2007) and The Little Book of Sideways Markets (Wiley, 2010).  His books were translated into eight languages.  Forbes Magazine called him “The new Benjamin Graham”.  

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:

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

Front Matter with Foreword by Jason Dyken MD MBA

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“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

 ***

Financial Advice Re-Invented for Medical Professionals?

cmp-logo

By Dr. David Edward Marcinko MBA CMP™

Dr David E Marcinko MBA

http://www.CertifiedMedicalPlanner.org

***

Introduction 

Much has been written, said and opined on this ME-P and elsewhere on financial advisory fees, commissions and other means of rumination.

So, what method is really best for the physician or other client? Full service, discounted fee for service, AUMs, commissions, wrap fees, ETFs, load or no-load mutual funds, annuities, stocks or individual bonds, etc? Oh! Did I forget the current [higher] fiduciary standard versus [lower] suitability conundrum? And now, the latest fad is the … Robo-Advisor service.

Of course, the very need for any sort of “professional” financial advisor is often questioned by the DIYer.

The Need

According to some research however, a financial advisor can help improve an investor’s net portfolio returns over time by building a portfolio with low-cost investments, minimizing taxes, and serving as an investing coach during volatile times in the market.

Source: Francis M. Kinniry Jr., Colleen M. Jaconetti, Michael A. DiJoseph, and Yan Zilbering, 2014. Putting a value on your value: Quantifying Vanguard Advisor’s Alpha. Valley Forge, Pa.: The Vanguard Group. For a copy of the research paper, visit vanguard.com/advisorvalue

***

cmp-program1

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The Vanguard Personal Advisor Services

With a new offering from Vanguard Personal Advisor Services, you’ll purportedly work with a financial advisor who’s a Certified Financial Planner® professional. Your dedicated advisor will:

1. Get to know you, your goals, and your unique financial situation.
2. Partner with you to create a custom-tailored financial plan.
3. Put your plan into action and manage your portfolio, allowing you to be as involved as you want to be.
4. Monitor your plan’s progress and keep you informed.
5. Rebalance your portfolio as necessary and partner with you to revise your plan when important changes in your life occur.

Assessment

And, just as you’d expect from Vanguard, the cost for this service is low, about one-third the industry average.

But alsa, no such relationship exists for medical professionals from a Certified Medical Planner™

Source: PriceMetrix, 2013. The industry average fee is 0.99% annually of assets under management compared with Vanguard’s annual cost of only 0.30% of assets under management. For a copy of the complete report, go to pricemetrix.com. Advisor fees may differ depending on the type and nature of the services offered.

More:

Become a CMP

Full Disclosure: I am not affiliated with Vanguard Advisory Services in any way.

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:

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

Front Matter with Foreword by Jason Dyken MD MBA

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“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

***

Buying Warren Buffett, Richard Branson and Steve Jobs at a Discount

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On capital allocators with impressive records

vitaly

By Vitaliy Katsenelson CFA

What would you get if you crossed Warren Buffett, Richard Branson and Steve Jobs? Answer: Masayoshi Son, the Korean-Japanese, University of California, Berkeley–educated founder of one of Japan’s most successful companies, SoftBank Corp.

***

interview

[A capital allocator]

***

Masayoshi Son

Just like Buffett, Son is a tremendous capital allocator with a very impressive record: Over the past nine and a half years, SoftBank’s investments have had a 45 percent annualized rate of return. A big chunk of this success can be attributed to one stock: Chinese e-commerce giant Alibaba, a $100 million investment SoftBank made in 2001 that is worth about $80 billion today. Though you may put Alibaba in the (positive) black swan column, Son’s success as an investor goes well beyond it — the list of his investments that have brought multibagger returns is very long. Today, at the tender age of 57, he is the richest man in Japan, and SoftBank, which he started in 1981 and owns 19 percent of, has a market capitalization of $72 billion.

Son, like Apple co-founder Jobs, is blessed with clairvoyance. He saw the Internet as an amazing, transformative force well before that fact became common knowledge. In 1995 he invested in a then-tiny company, Yahoo!, earning six times his investment. But he didn’t stop there; he created a joint venture with Yahoo! by forming Yahoo! Japan, putting about $70 million in a company that today is worth around $8 billion. (Yahoo! Japan is a publicly traded company listed in Japan).

What is shocking is that Son saw that the iPhone would revolutionize the telecom industry before Apple announced it or even invented it. See for yourself in this excerpt from an interview with Charlie Rose, where Son describes his conversation with Jobs in 2005 — two years before the iPhone was introduced:

“I brought my little drawing of [an] iPod with mobile capabilities. I gave [Jobs] my drawing, and Steve says, “Masa, you don’t give me your drawing. I have my own.” I said, “Well, I don’t need to give you my dirty paper, but once you have your product, give me for Japan.” He said, “Well, Masa, you are crazy. We have not talked to anybody, but you came to see me as the first guy. I give to you.”

Richard Branson

Similar to Virgin Group founder Branson, who had the testicular fortitude to create Virgin Atlantic Airways in the U.K. to compete against the state-owned behemoth British Airways, Son started two telecom businesses in Japan — one fixed-line and one wireless — with which he challenged the state-owned NTT monopoly. In 2001, disgusted with Japan’s horrible broadband speeds, he convinced the government to deregulate the telecom industry. When no other companies emerged to compete with NTT (I don’t blame them, really), Son took it upon himself to start a fixed-line competitor, Yahoo! BB (Broadband). Thanks to him, now Japan enjoys one of the highest broadband speeds in the world and Yahoo! BB is a leading fixed-line telecom.

It took Son four years to bring his broadband business to profitability. This is how the Wall Street Journal described that period in 2012:

“The problems at the broadband unit contributed to losses for the entire company for four consecutive years. Mr. Son set up an office in a meeting room 13 floors below his executive suite to be closer to the problem unit. He slept in the office at times and routinely summoned executives and partners for meetings late at night. . . . He worked out of the meeting room for 18 months, until the broadband unit had cut enough costs and moved enough customers to more lucrative plans.”

A normal person might have taken a break and enjoyed the fruits of his labor at that point, but not Son. Just as his broadband business went in the black, Son executed on his vision for the Internet and bought Vodafone K.K., a struggling, poorly run wireless telecom in Japan. SoftBank paid about $15 billion, borrowing $10 billion.

Fast-forward eight years, and SoftBank Mobile is an incredible success. It is one of the largest mobile companies in Japan, even faster growing than NTT Docomo (a subsidiary of almighty NTT). Today it spits out about $5 billion in operating profits annually — not bad for a $5 billion equity investment.

Like Branson, Son is a serial entrepreneur who has started multiple, often unrelated businesses and has succeeded a lot more than he has failed. SoftBank has built a robot named Pepper that can read human emotions; and after the earthquake that crippled Japanese power generation, Son started a renewable-energy business.

Son has a very ambitious goal for SoftBank: He wants it to become one of the largest companies in the world. Unlike the average Wall Street CEO, whose time horizon has shrunk to quarters, Son thinks in centuries. I kid you not — he has a 300-year vision for SoftBank. Practically speaking, 300 years is a bit challenging even for long-term investors, but at the core of his vision Son is building a company that he wants to last forever (or 300 years, whichever comes first).

He views SoftBank as an Internet company and is committed to investing in Internet companies in China and India. He thinks that as these countries develop, their GDPs will eclipse those of the U.S. and Europe.

Jobs, Branson, Buffett — it is very rare for somebody to embody strengths of all three of these giants. None of them has the qualities of the other two. Buffett is not a visionary, nor does he want to run the companies in his portfolio. Branson is not a visionary — in his book Losing My Virginity he admits he did not see analog music (CDs) being destroyed by digital music (iTunes) and demolishing his music store business. Jobs probably came the closest, as both a visionary and a business builder, but he was not known for his investing acumen.

You’d think SoftBank would be richly priced to reflect Son’s premium. Wrong! Today its stock is trading at about a 40 percent discount to the fair value of its known assets (SoftBank has about 1,300 investments, many of them not consolidated on its financials).This discount is not rational, but maybe the market thinks Alibaba is overvalued, or it expects the Japanese yen to continue its decline (I would not disagree), and thus wholly owned Japanese telecom businesses are going to be worth less in U.S. dollars. Or maybe SoftBank’s Sprint investment is not going to work out. Oh, I forgot to mention that one — let’s address it next.

SoftBank’s Japanese telecom businesses generate about $6 billion of very stable operating income, but there is little room for growth in Japan. Unable to find anything telecom to buy in Asia, in 2013 the company took advantage of the strong yen and bought 80 percent of Sprint for $21 billion, or $7.65 a share. Sprint is the No. 3 mobile company in the U.S., a market dominated by AT&T and Verizon, which together account for about 75 percent of wireless revenue and more than 100 percent of wireless profits (T-Mobile and Sprint are losing money). If I knew no more than that, I’d say Sprint’s chances of success in the U.S. are slim — after all, it is competing against two very profitable giants.

But I would have said the same thing about SoftBank’s adventure into fixed-line and then wireless in Japan, and I would have been dead wrong. Admittedly, Sprint’s turnaround will not be easy and will be far from linear, and its $30 billion debt load will not help. SoftBank is looking to apply the tremendous experience it gained through a lot of hard work in turning an ailing Vodafone K.K. into one of the best wireless companies in the world.

However, this time around SoftBank is even better equipped to fight its competition: It has lots of experience with 2.5 GHz spectrum in Japan, where its network is several times faster than Verizon’s and AT&T’s networks in the U.S. SoftBank brought 200 engineers from Japan to help Sprint design its new network; the two companies combined have tremendous buying power in equipment, second only to China Mobile. In fact, suppliers Alcatel-Lucent, Nokia and Samsung just agreed to provide Sprint with $1.8 billion in vendor financing. But most important, SoftBank has already had success with a telecom turnaround. It is following the same road map with Sprint that it used in Japan with Vodafone K.K.: improve the network, cut costs, provide better customer service and top all that with cutthroat price reductions.

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investmentcenter5

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Sprint News

Over the past several months, the news flow from Sprint has not been great: It cut guidance, and its stock declined to $4 a share. This may explain why SoftBank’s stock is down; however, even if Sprint meets its maker, the impact on SoftBank should be just $5 a share. Sprint’s $30 billion debt is nonrecourse to SoftBank. Even at current market values, SoftBank’s equity stake in Sprint is worth only $12 billion, while its 32 percent stake in Alibaba is worth $80 billion, and its Japanese telecom businesses are worth about $50 billion (at five times earnings before depreciation and amortization). SoftBank’s stake in Yahoo! Japan is worth north of $8 billion.

Softbank

As part of our investment analysis, we tried to hypothetically kill SoftBank — smother it with a pillow — but we simply could not. We assumed that the yen will depreciate against the dollar to 180 from 120 today, slashing the value of Japanese businesses by a third. Alibaba stock is trading at around $100, about 30 times 2015 earnings forecasts; we took the earnings multiple down to 20 times, pricing the stock at $60. We even assumed SoftBank will have to pay capital gains taxes on selling Alibaba. We halved the price of Sprint’s stock. However, even in this fairly grim scenario we could not get SoftBank’s stock to decline much below its current price of $30. In the worst case we are paying fair value for SoftBank’s assets and get Son’s magic for free. This places no value on his 1,300 other investments, either. Sprint may, by the way, actually work out to be a tremendous success for SoftBank.

There are many ways to look at SoftBank. You can think of it as buying a stock at a roughly 50 percent discount to the market value of its assets or as a way to buy Alibaba at less than half its current price. Alibaba is a great play on China — not the China that builds ghost towns and bridges to nowhere but the Chinese consumer, and not just the Chinese consumer but the Chinese consumer who is spending more and more money shopping online. Alibaba is synonymous with Chinese online shopping, whose growth may accelerate with higher smartphone penetration and, just as important, the ongoing rollout of a fast wireless LTE network.

I’d be remiss if I did not discuss an important asterisk in the ownership of Alibaba. Its shares listed on the NYSE and owned by SoftBank don’t have an economic interest in Alibaba, although, through a stake in a Cayman Islands entity, they have contractual rights to profits from Alibaba China. The latter is owned and controlled by Jack Ma, Alibaba’s founder and CEO. This structure is not a by-product of Ma’s evil intent to steal Alibaba from gullible investors but rather is forced by Chinese law that prohibits foreign ownership in certain industries. There is a risk that the Chinese government might find this structure illegal, but at Alibaba’s size — $240 billion — the company is simply too big to be messed with. China’s economy would pay a huge price if its second-largest public company just disappeared due to a legal technicality. This would also turn into an international public relations nightmare for China, not only with the U.S. but with Japan as well. It would make Ma richer at the expense of U.S. shareholders but also at the expense of SoftBank and Japan’s richest man, Son.

(Those who have a problem with Ma maintaining complete operational control of Alibaba should recall that the phenomenon of founder as benevolent dictator is nothing new — just look at Google. In fact, I’d argue that this control has allowed Ma to sustain his long-term time horizon and this is what has helped Alibaba drive eBay out of China; but that’s a discussion for another time).

Assessment

You can also look at SoftBank as a vehicle through which to invest in emerging markets — not just China but India as well. It is almost like hiring the combination of Buffett, Branson and Jobs to go to work for you investing in markets whose economies in a few decades will surpass that of the U.S., while also investing in a segment of the economy — the Internet — that is growing at a much faster rate than the overall economy. And yes, of course, you have Masayoshi Son, the super-Buffett-Branson-Jobs fusion, making these investments for you. With SoftBank at this valuation, you can forget about your emerging-markets mutual fund.

More: Ode to Steve Jobs

ABOUT

Vitaliy N. Katsenelson, CFA, is Chief Investment Officer at Investment Management Associates in Denver, Colo.

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Front Matter with Foreword by Jason Dyken MD MBA

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What does “Retirement” mean to You?

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A Mental Exercise … for You!

By Rick Kahler MS CFP® http://www.KahlerFinancial.com

Rick Kahler MS CFPHere’s a brief mental exercise to try: Quickly, without stopping to think, write down what comes to mind when you imagine yourself being retired.

If you’re 40 or younger, your answers might well include terms like “future” and “old age,” which probably don’t seem especially relevant or urgent at this stage in your life.

If you’re older, chances are you’ve had at least passing thoughts about retirement. You might associate it with concepts like these:

  • Freedom from the daily grind
  • Losing my earning power
  • Losing my identity
  • Enjoying financial independence
  • Being useless
  • Dependency and declining health
  • Doing what I’ve always wanted to do
  • I don’t ever plan to retire

Both the positives and negatives in the above list have one thing in common: they don’t tell the whole story. The idea of retirement is surrounded by a host of delusions, assumptions, and fears. Many of our expectations about it do not match the reality.

Examples:

Here are just two examples from “The 2013 Risks and Process of Retirement Survey,” done by the Society of Actuaries.

  • Of the pre-retirees surveyed, 38% expected to work until at least 65. Another 15% expected not to retire at all. Yet 54% of the retirees surveyed had retired before age 60.
  • Many pre-retirees—59%—planned to stop working gradually. Yet only 22% of retirees had done so. While 35% of pre-retirees intended to keep working part-time, only 10% of retirees actually did.

It’s no wonder that many workers plan to stay employed; they’ll need the money. The 2015 Transamerica Retirement Survey of Workers estimates the median amount that workers in their 50s have saved for retirement at only $117,000. For workers in their 60s and older, it is $172,000. Even combined with Social Security, that’s hardly enough to provide an adequate retirement income.

Yet even if you intend to keep working and earning until you’re 80, you may find your plans derailed. If companies downsize, older workers may be among the first to be laid off. Health problems (your own or those of family members you may need to care for) can force you to retire earlier than you expected to.

And, these are only two of the unfortunate realities that can jolt any of us out of our rosy expectations of enjoying a carefree retirement of good health, comfort, and independence.

Just because we can’t count on carrying out our retirement plans, though, doesn’t mean we should give up on retirement planning altogether.

Some Suggestions

Here are a few suggestions to deal with the realities of retirement:

  1. Save as much as you can. Make funding retirement your priority, especially if it’s too late to start early. Cut your spending, downsize, and pay off debt. Having more money in retirement gives you more options when bad things do happen.
  1. Improve your health: lose weight, exercise more, and eat a healthy diet. Improve your odds for staying well by changing what is within your power to change.
  1. Look at the whole retirement picture. Become willing to consider both the negative and positive possibilities in order to plan appropriately. Unreasonable pessimism and fear are no more realistic than unreasonable optimism.

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7 ways retirement income

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Assessment

Finally, the most realistic viewpoint may be accepting that retirement is no more or less predictable than any other stage of life. We can’t know if we’ll develop serious health problems in our 70s or still be able to go dancing when we’re 102. While we can and should prepare for the future, we also serve ourselves well when we remember to enjoy the present.

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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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

I plan to give a copy of this book written by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic.

Alexander Naruska CPA [Orlando, Florida]

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R.I.P. these Industry Sectors?

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Can You Think of any Others?

[By Staff Reporters]

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RIP Tech

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

Product DetailsProduct Details

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2015 Kent State University College of Podiatric Medicine Holds “White Coat” Ceremony

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Welcome the New KSUCPM “White-Coats”

[By Staff Reporters via PMNews August 14, 2015 #5,445]

Kent State University College of Podiatric Medicine (KSUCPM) recently celebrated the Class of 2019 White Coat Ceremony. The College of Podiatric Medicine welcomed 122 students into the Class of 2019. The ceremony was held in the University Auditorium at Cartwright Hall on the Kent Campus in Kent, OH.

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KSCPM

KSUCPM Class of  2019 at White Coat Ceremony

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Dean Speak

Dr. Allan M. Boike DPM, Dean, stated, “I am very pleased to welcome this remarkable group of students to Kent State University. This class represents 35 states, as well as four nations.”

Keynote Speaker Speak

Dr. Karen Kellogg served as the keynote speaker. She received a Doctorate of Podiatric Medicine from the Ohio College of Podiatric Medicine in 2000. And, she completed a three-year podiatric surgery residency at Dunlap Memorial Hospital in Orrville, OH.

More: 2015 Harvard Medical School Class

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

Product DetailsProduct Details

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The Role of Master Data Management in Health Care

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By MCOL.com

Where are you in the business and data analytics roadmap?

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[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

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PRACTICE RISKS IN CORRECTIONAL CARE MEDICINE

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Some Thoughts and Some Statistics

dr-david-e-marcinko-mba-msl[By Dr. David Edward Marcinko MBA]

Most primary care doctors, psychologists and psychiatrists who work in corrections long enough will end up being named in a lawsuit or having a complaint filed against them with their licensing board.

And, it is a fact that physicians who treat inmates are at greater risk of litigation.

Bureau of Justice Statistics

According to the 2011-12 National Inmate Survey conducted by the Bureau of Justice Statistics:

  • Half of state and federal prisoners and jail inmates reported a history of a chronic medical condition.
  • About 2/3 of females in prisons (63%) and jails (67%) reported ever having a chronic condition
  • An estimated 40% of prisoners and inmates reported having a current chronic medical condition.
  • About 1 in 5 (21%) of prisoners and 14% of jail inmates reported ever having an infectious disease.
  • Approximately 1% of prisoners and jail inmates reported being HIV positive.
  • High blood pressure was the most common condition reported by prisoners (30%) and inmates (26%).
  • Nearly a quarter (24%) of prisoners and jail inmates reported ever having at least 2 chronic conditions.
  • 66% of prisoners and 40% of jail inmates with a chronic condition reported taking prescription medication.And, although specific figures are not available, malpractice carriers are quite aware of this risk.

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gavel stethoscope

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Risks Not a Work Deterrent

Yet, according to colleague Eric A. Dover MD and Jeffrey Knuppel MD, a psychiatrist who blogs at The Positive Medical Blog, the risk of litigation should not be a deterrent to working as a health care professional in correction facilities if:

1. You truly like working in the correctional setting. This work is not for everyone. If you don’t really like it anyway, then the thought of getting sued is just likely to decrease your career satisfaction further.

2. You have ability to be assertive yet get along well with most people. If you frequently find yourself in power struggles with people or cannot politely set limits, then do not work in corrections. If you let your ego get involved in you interpersonal interactions very often, then you’re likely to irritate many inmates, and you probably will become a target for lawsuits and complaints [personal communication]. 

Conclusion

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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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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™

“With time at a premium, and so much vital information packed into one well organized resource, this comprehensive textbook should be on the desk of everyone serving in the healthcare ecosystem. The time you spend reading this frank and compelling book will be richly rewarded.”

Dr. J. Wesley Boyd MD PhD MA [Harvard Medical School, Boston, Massachusetts]

A [Physician] Investor’s Worst Enemy?

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Fear of Missing Out

By Lon Jefferies CFP MBA

Lon JefferiesFear of missing out (FOMO) is an increasingly powerful emotion in our daily lives – so much so that FOMO was officially added to the Oxford English Dictionary in 2013.

DEFINITION

Have you ever looked at your Facebook feed and been jealous of someone’s picture from a beautiful viewpoint, or enviable of a friend’s photo of an expensive dinner with a strategically placed bottle of fancy wine in the background?

That is FOMO – the fear that at any given moment someone is doing something more appealing than what we are doing at the time.

Part of Life

A fear of missing out has always been part of life, but it has become more prevalent with the emergence of social media. Personally, I can’t help but check my Twitter feed every hour or so to make sure that I’m not missing out on an article published by one of my favorite financial writers. Yet, social media has increased the power of FOMO more than I realized.

Example

I have absolutely zero interest in horse racing – frankly, I dislike the sport. However, due to all the hype on Facebook and Twitter, I couldn’t help but watch the Belmont Stakes out of fear of missing American Pharaoh become the first Triple Crown winner of my lifetime.

FOMO is frequently a counter-productive emotion, leading to jealousy of others, dissatisfaction with our own lives, and bad decision-making processes. Nowhere is the negative impact of FOMO more apparent than in some individuals’ investment strategy. For years, no one has enjoyed going to the neighborhood BBQ only to have to listen to their next door neighbor brag about how his portfolio has outperformed the S&P 500 index over the last six months. Not only is listening to the boasting annoying, it makes us discontent with the return our own portfolio has achieved and makes us wonder if we should adapt a different strategy (i.e. take more risk right after the market achieved a new all-time high).

Social media has expanded the impact of FOMO on investment strategies. For the last year, the internet has ensured we are aware that large cap indexes like the S&P 500, Dow Jones Industrial Average, and NASDAQ are at all-time highs and achieving appealing returns, and we wonder why our more diversified portfolio isn’t behaving in a similar fashion. It is hard to be content with our diversified strategy when every media outlet is constantly reminding us how we are missing out on the stellar performance that could be obtained if only we had a non-diversified portfolio that invested only in the asset category that is currently in the middle of a hot streak.

When it comes to investing, FOMO is significantly impacted by recency bias. Our fear of missing out becomes more and more intense after the market has just experienced an uptick. If we take a couple of steps back, it is clear why we maintain a diversified portfolio – it provides the most appealing tradeoff between maximizing returns and minimizing risk.

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FOMA
                                

Fear Of Missing Out

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Yet, it is hard to remind ourselves of this when it seems like everyone around us is taking advantage of the latest market trends and we are missing out.

Of course, changing our portfolio to try and take advantage of a run that has already taken place would be foolish, as we would be selling assets with prices that have remained flat and may now be undervalued relative to the market in order to buy assets that have recently experience significant growth and are likely now expensive. These are the type of decisions that FOMO can cause and we would be wise to avoid this type of thinking.

A Re-Do?

We have been in this position before. In the late 1990s, people wanted to abandon their diversified portfolio and put a heavy focus on the technology stocks that were making all their neighbors rich. In the mid 2000s, everyone wanted to borrow as much money as possible and utilize the funds to buy and flip real estate.

In the early 2010s, everyone was wondering if they should sell their stocks before a double-dip recession began and use the resulting funds to buy gold. In each of these scenarios we were hearing individual stories of others who had implemented these strategies and were doing better than we were.

Of course, with the benefit of hindsight, we can see that changing our long-term investment strategy due to a fear of missing out on what was working for others over a short time period would have been a drastic mistake in each of these circumstances. After the market has done well, recency bias and FOMO causes investors to be more afraid of missing a bull market than of suffering large losses.

However, in these times, we need to remember that we chose a diversified investment strategy because it provides us with the highest probability of obtaining our financial goals while exposing us to the least amount of volatility possible.

Assessment

When the media and our acquaintances insist on informing us how we would have been better off placing heavy bets on the asset categories that have recently done well, we would be well served to remember that a diversified portfolio strategy will almost certainly provide us with the best chance to achieve long-term investment success. 

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:

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

Front Matter with Foreword by Jason Dyken MD MBA

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Ratio of [Start-Up] Deals Reviewed to Investments [Ultimately] Made

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Top Ten Most Innovative Healthcare Companies of 2015

Medical Entrepreneurs – Take Note!

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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David Cummings on Startups

Recently, I was reading the limited partner quarterly updates for a fund where I’m an investor. In the update, the author highlighted that the fund had reviewed 1,000 potential deals last year and invested in four companies. At a ratio of 250:1, it’s clear that there are many more startups trying to raise a Series A than there are Series A investments (see the Series A crunch talked about four years ago).

Here’s how the investment process might work at a venture fund:

  • 250 deals reviewed
  • 25 one-on-one pitches (where the entrepreneur pitches a single partner)
  • 5 full partner pitches (where all the partners hear the pitch)
  • 2 term sheets
  • 1 investment

Raising money is much harder than most entrepreneurs expect. With funds seeing so many opportunities, but only being able to invest in 1-2 companies per year per investor, it’s clear that most entrepreneurs will feel rejected when out raising…

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The Ever Changing “Standard of Medical Care”

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Lard and Nicotine

Via Hend:

According to Wikipedia, a standard of care is a medical or psychological treatment guideline, and can be general or specific. It specifies appropriate treatment based on scientific evidence and collaboration between medical and/or psychological professionals involved in the treatment of a given condition.

Some common examples:

1. Diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance. Adjuvant chemotherapy for lung cancer is “a new standard of care, but not necessarily the only standard of care”. (New England Journal of Medicine, 2004)

2. In legal terms, the level at which an ordinary, prudent professional with the same training and experience in good standing in a same or similar community would practice under the same or similar circumstances. An “average” standard would not apply because in that case at least half of any group of practitioners would not qualify. The medical malpractice plaintiff must establish the appropriate standard of care and demonstrate that the standard of care has been breached, with expert testimony.

3. A physician also has a “duty to inform” a patient of any material risks or fiduciary interests of the physician that might cause the patient to reconsider a procedure, and may be liable if injury occurs due to the undisclosed risk, and the patient can prove that if he had been informed he would not have gone through with the procedure, without benefit of hindsight. (Informed Consent Rule.) Full disclosure of all material risks incident to treatment must be fully disclosed, unless doing so would impair urgent treatment. As it relates to mental health professionals standard of care, the California Supreme Court, held that these professionals have “duty to protect” individuals who are specifically threatened by a patient. [Tarasoff v. Regents of the University of California, 17 Cal. 3d 425, 551 P.2d 334, 131 Cal. Rptr. 14 (Cal. 1976)].

4. A recipient of pro bono (free) services (either legal or medical) is entitled to expect the same standard of care as a person who pays for the same services, to prevent an indigent person from being entitled to only substandard care.

Source: https://en.wikipedia.org/wiki/Standard_of_care

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B2Q2bSgCUAAu4Aw

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doctors-smoke-camel

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Assessment

We may not recommend this today, but back in the day…..?

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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™

Understanding International Bond Advantages?

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In Global Investable Markets

tim[By Timothy J. McIntosh MBA CFP® MPH]

International bonds now account for more than 35% of the world’s investable assets, and yet many physicians and other investors have little or no exposure to these types of securities. International fixed income securities make up a noteworthy portion of the global investable market.

While investors in international bonds are exposed to the hazard of interest rate movements and political risks, the principal factors driving international bond prices are actually uncorrelated to the most common U.S. risk factors. This indicates a true diversification benefit for any investor. International bonds have become more prominent and attractive due to the increase in globalization and the pervasive expansion of debt issuance overseas, primarily by governments. There has been a near doubling of the relative weight of the non-U.S. bond market from approximately 19% in 2000 to approximately 37% in 2011.  Thus, there is more selection of international bonds than ever for U.S. investors.

***

shaking-hands

[Global Debt Markets]

***

Investing in international bonds involves contact to the movements of global currencies. This is the primary component of determining international bond returns.  Alternations in currencies create an extra layer of volatility in these types of securities.

However, that volatility actually enhances diversification benefits.  One of the key considerations of any purchase of international bonds is whether or not to hedge the currency impact.  These deviations create return volatility above the level inherent to the underlying investment. An allocation to an unhedged international bond does reflect an investor’s bearish view of the U.S. dollar.  This is because as the dollar depreciates against a foreign currency, an international bond will gain in value.  The last 25-plus years have witnessed a long-term decline in the U.S. dollar, actually providing a tail wind for international bond investors.

***

russian bonds

[Russian Bond]

***

In fact, according to data from Vanguard, unhedged international bonds outperformed hedged bonds by 2.2 percentage points a year since 1987. The diversification benefit from international bonds is also attractive.

For example, from January 1, 1992 to March 31, 2013, the correlation between the Citigroup World Government Bond Index ex-US 1-3 Years index and five-year U.S. Treasury notes was a mere 0.35.  An allocation to international bonds can amplify portfolio diversification across economies, currencies, and yield curves.

***

IMG_0737

[iMBA Inc., in Moscow]

***

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ABOUT

Timothy J. McIntosh is Chief Investment Officer and founder of SIPCO.  As chairman of the firm’s investment committee, he oversees all aspects of major client accounts and serves as lead portfolio manager for the firm’s equity and bond portfolios. Mr. McIntosh was a Professor of Finance at Eckerd College from 1998 to 2008. He is the author of The Bear Market Survival Guide and the The Sector Strategist.  He is featured in publications like the Wall Street Journal, New York Times, USA Today, Investment Advisor, Fortune, MD News, Tampa Doctor’s Life, and The St. Petersburg Times.  He has been recognized as a Five Star Wealth Manager in Texas Monthly magazine; and continuously named as Medical Economics’ “Best Financial Advisors for Physicians since 2004.  And, he is a contributor to SeekingAlpha.com., a premier website of investment opinion. Mr. McIntosh earned a Bachelor of Science Degree in Economics from Florida State University; Master of Business Administration (M.B.A) degree from the University of Sarasota; Master of Public Health Degree (M.P.H) from the University of South Florida and is a CERTIFIED FINANCIAL PLANNER® practitioner. His previous experience includes employment with Blue Cross/Blue Shield of Florida, Enterprise Leasing Company, and the United States Army Military Intelligence.

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:

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

“Physicians who don’t understand modern risk management, insurance, business and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners.

This comprehensive volume from Dr. David Marcinko, and his co-authors, will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.”

Dr. James M. Dahle MD FACEP

[Editor of The White Coat Investor, Salt Lake City, Utah, USA]

http://www.CertifiedMedicalPlanner.org

***

Dealing with Patients Who Refuse to Pay

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Is your credit card on file?

[By Ann Miller RN MHA]

Handling patients with high deductibles health care plans and/or who refuse to pay in the ACA era is a growing financial risk for private medical practitioners. To help ameliorate the issue, some doctors are using a “credit card on file” program.

Enter “Credit-Card-on-File” Programs

Athenahealth has such a program where, once each year, the doctor swipes the credit card of each patient. Athena’s credit card partner (Elavon) stores the credit card information securely. The patient signs a one-year contract that gives permission to bill that card for any outstanding balances. This is the same concept as having a hotel swipe your credit card when you check-in but not bill you until you have checked-out.

Then, as soon as insurance has adjudicated the claim, the patient receives an email informing them that their credit card will be charged for the remaining balance in 5 days. If they have any issue with the bill they can contact the doctor’s office in that 5 day period. If not, their credit card is automatically charged for the balance due after 5 days. No work on the doctor’s office part is required once the card is swiped.

***

Reading the Fine Print of a Legal Agreement

Reading the Fine Print of a CC on file agreement

***

Assessment

Advantages include no need to send out patient statements, and days-in-AR for patient balances is reduced. And, essentially no staff time is spent collecting patient balances.

Another company (managemypractice.com) offers helpful online courses on how to set this up a credit card on file program regardless of system used.

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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™

“This comprehensive text book provides an in-depth presentation of the cyber security and real risk management, asset protection and insurance issues facing all medical profession today. It is far beyond the mere medical malpractice concerns I faced when originally entering practice decades ago.”

Dr. Barbara s. Schlefman MA [Family Foot Care, PA, Tucker, Georgia]

***

 

Blogging for Medical Practice Promotion?

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Strategic Questions for Doctors to Consider

[By staff reporters]

There’s all sorts of advice on why and how to blog in order to promote a medical practice. Yet, most doctors STILL haven’t scratched the surface to understand what blogging is actually about and what roles it may play in their overall Business Plan and strategic presence – on and offline.

But, all practices have different concerns and goals, and every media, communications and marketing strategy is different from the other.

Today, “blogging” just doesn’t mean the publishing of content on a website. It’s more about being proficient in various media: from traditional to emerging; a new set of skills every doctor or physician executive needs to acquire and hone. Blogging is a constant learning process. It’s also a way to reveal strengths and weaknesses inherent in any healthcare organizations, culture and processes.

***

Blog

***

The Expert Speaks?

According to Phil Baumann RN, of Phil.Baumann.com, the following are helpful to consider when planning a blogging campaign to promote your medical practice:

  1. What’s the purpose? Practice development? Patient availability? A place to house your medical expertise and knowledge? A place to create a [professional or patient] community where ideas and questions can be explored openly? What value do you expect to provide or extract?
  2. Who is your audience(s)? Are you thinking that your only audience would be patients? Or, perhaps your colleagues, other healthcare industry influencers, vendors or the public? Will you be able to track the social footprint of your audience – who they are and where else on the Web they interact?
  3. What kinds of content are you delivering? Is it informational? Editorial? Inspirational? Industrially insightful? Action-calling? How might the kind(s) of content and information you publish influence your audience? Are you willing to let your audience help determine your content?
  4. What kinds of media will you provide on the blog? Text? Video? Audio? Slidedecks? Different media have different properties. Have you thought about the properties of traditional media and how they differ from emerging media? How much of your traditional practice marketing expertise evolved around the properties of print, radio, traditional websites and TV? Given that new media possess different properties, how might your marketing and promotional strategies need to adapt?
  5. Do you know what kinds of assets a blog can build? Appointment leads? A small but relevant community of patients or influencers? Professional or street credibility? Search engine optimization [SEO] and ranking? Which do you need?
  6. How will you distribute your content? Have you developed other web real estate – outposts on Facebook, Twitter, Youtube, Slideshare; or will you use strictly medical networks, healthcare related platforms or build your own? Which ones make the most sense to invest in? Can you build a visual map of your entire Web presence and how different Web and traditional presences relate to the bigger picture?
  7. If you successfully build your community, do you know how to leverage it? Will you be satisfied to just have visitors? Or, will you engage with your community – not only on your blog but elsewhere? Will you continually monitor your efforts and make the best of the connections you make? Will you develop a system to reach your community beyond your blog – either via email or other media outreach?
  8. Do you think blogging is just putting content on a website – or do you believe it is a spectrum of media skills? What’s your conception of medical practice blogging? Might there be more to blogging than what you think you know? What skills may you need to develop or build upon
  9. Do you have a plan on how to distribute your blog content to traditional media (where else is your audience)? What are your overall communications and marketing strategies? How might emerging media not only play a part, but how might their proliferation impact your established practice strategies?
  10. How committed will you be? Is this going to be a chore “to be done” or will you intelligently integrate it into your promotional routine? Do you understand the skills and resources needed to become proficient? When thinking about resources, are you considering time and talent and networks? Or, will you outsource, and can you afford it?
  11. Do you have the stamina to sustain your efforts in the long-term? Investing in new media is about sustaining long-term capital. Given your resources, will you create the kind of working environment for your employees to enjoy the art of creating content, conversing across different networks and advancing the practice’s objectives?
  12. Do you know how to make it easy (and enticing) for your audience to comment? Will you thank and comment back? Is sharing via email and other sources easy?
  13. Are you willing to fail? More importantly: how do you define failure? This is important to know because if you define failure appropriately, then you’re more likely to know what to do when you encounter it: in fact, you may see it as a huge opportunity.

***

hipster

***

Assessment

Take your time answering these questions because they aren’t just about blogging: they’re about your understanding promotional media and your medical practice. What other questions do you think you need to ask yourself?

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Online Doctor Reputation Management

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How doctors can protect their online reputation

A continuing series on physician online reputation.  Created in partnership with The Doctors Company as part of their social media resources for physicians

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 [Foreword Dr.Mata MD CIS]

RIP Dr. Frances Oldham Kelsey … and other GIANTS

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FDA scientist who kept thalidomide off U.S. market

***

thalidomide (C) FDA, All rights reserved. USA

***

Frances_Oldham_Kelsey

https://en.wikipedia.org/wiki/Frances_Oldham_Kelsey

***

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***

CMS Home Health Agencies

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Star Ratings

By http://www.MCOL.com

MEDICARE @ 50 [1965-2015]

ImageProxy

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***

Blue Cross Blue Shield, Independent / Provider – Sponsored Plans

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Transcripts and Slides

DougBy Douglas B. Sherlock, CFA sherlock@sherlockco.com

The Affordable Care Act is intended to create strong incentives to reduce the administrative costs of health insurers. The medical loss ratio rules and the new ACA-related taxes are manifestations of this policy, and the recent announced business combinations between leading national health insurers are adaptations to these incentives.

It follows that the most recent rate of increase in health plan administrative expenses, excluding the new taxes, is dramatically lower than in recent years. Sherlock Company materials summarizing the results of our surveys are found below.

Independent / Provider – Sponsored Plans

Blue Cross Blue Shield Plans

Assessment

The contents above are a very small portion of the 1,000 page Sherlock Benchmarks for each of these universes. The Sherlock Benchmarks are essential tools to manage administrative costs for your health plan.

budget

Conclusion

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[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP]

***

Beware of Sideways Markets

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Are We There … Yet?

By Vitaliy N. Katsenelson CFA

vitaly

NOTE: This article was first written in May 2013, but it is still as relevant today as it was then.

Preface

In early May 2015 I had the pleasure of attending and speaking at the Value Investing Congress in Las Vegas. The last time I had spoken there, it was May 2008 and the market was just coming off its top.  The Standard & Poor’s 500 index was trading at 18 times trailing earnings. Profit margins were at a modern-day high. They subsequently collapsed but came back to set an even higher high. If you normalize profits for high margins and look at ten-year trailing earnings, in 2008 stocks were trading 66 percent above their average. They were at 30 times ten-year trailing earnings.

The Market Repeats

In all honesty, I could do the same presentation today that I did five years ago, since market valuation is not dramatically different from what it was then. A cyclical bear and a cyclical bull market later, the S&P 500 is at (the same) 18 times trailing earnings and 26 times ten-year trailing earnings. Investors who were on the sidelines the past few years and who are now pouring money into stocks, expecting that we are in the midst of a secular bull market, will likely be disappointed. The previous sideways market, of 1966–82, included four cyclical bull markets and five cyclical bear markets. From 1970 to 1973 the Dow went from 700 to 1,000, just to drop again, to 600.

Lost Hope

Sideways markets are there to destroy hope. It is when nobody wants to own stocks ever again, when valuations are below their historical average, that a secular sideways market finally dies (actually, more like goes into hibernation), and the next secular bull market is born. But even that is not enough: Stocks need to spend time at below-average valuations. In the 1966–82 market they spent half of their time at below-average valuations. During the recent crisis we tiptoed into below-average valuations, but we danced right back out.

A present day secular bull market?

To believe we are in the midst of a secular bull market, you have to be very comfortable with three things, starting with profit margins.

  1. Today corporate profit margins are hitting all-time highs. Historically, profit margins have been mean-reverting — high margins were never sustained by corporations over a prolonged period of time because, as legendary value investor Jeremy Grantham puts it, “capitalism works.”  When a company — Apple, for example — starts earning very high margins, its competitors (like Samsung) come in with lower prices. In response, Apple must lower its margins. If margins decline even as the economy grows, earnings growth will be very benign or negative.
  2. Second, even if you are comfortable with high profit margins, you have to make an assumption that economic (revenue) growth will be robust going forward. Given how many headwinds we are facing from Europe, China and Japan, it is hard to develop a high comfort level there.
  3. And finally, you have to believe that price-earnings ratios can expand from their current level. I have news for you: In the past, sideways markets started (bull markets ended) when valuations were at current levels.

Stock returns are driven by two variables, earnings growth and changes in P/Es. Earnings growth for the next five to ten years is unlikely to be exciting and may not even be positive, and P/Es are likely to change for the worse, not the better.

***

silhouettes chart

***

Interest rates

Interest rates were much higher in the ’70s and early ’80s than they are today, and thus stocks may deserve higher valuations than they did then. This applies to all assets. But, the Federal Reserve’s policy may inflate stocks’ valuations for a while. If the Fed succeeds and real growth resumes, then interest rates will rise and (expensive) stocks that were discounting all-time-low rates will get crushed. After all, they — like long-duration bonds — do great when interest rates decline and bite the dust when interest rates rise.

Of course, on many levels things are better now than they were in 2008. The financial crisis and real estate bubble are behind us; we are probably not going to see those again for a while. But their resolution came at a big price: much higher government debt and a command-control interest-rate policy that would have made the Soviets proud.

Today

We’re now living in a Lance Armstrong economy. We’ve consumed so many performance enhancement drugs through endless quantitative easing that it is hard to know how well the economy is really doing. Unfortunately, as Armstrong at some point did, we’ll have an Oprah Winfrey moment when the economy will have to fess up for all the QEs.

We are living through one of the most grandiose and untested lab experiments ever conducted by a central bank: QE Infinity. At the recent Berkshire Hathaway annual meeting, Warren Buffett said, “Watching the economy today is like watching a good movie — you don’t know the ending.” His sidekick Charlie Munger added, “If you are not confused about the economy, you don’t understand it very well.”

The FOMC

The Fed’s unprecedented intervention in the economy has increased the possible range and severity of negative outcomes, from runaway inflation to deflation or a freaky combination of the two (freakflation). Deflation (or freakflation) is not good for stocks or their valuations. Just look at Japan. Over the past 20 years, stock valuations declined despite interest rates being at incredibly low levels. Expensive stocks (as I’ve mentioned, stocks in general are very expensive) discount earnings growth. If growth fails to materialize, these P/Es will decline. Unknowns are simply unknown.

Caution

At a time when the market is making all-time highs, it is easy to become complacent and let your guard down. Don’t. • •

ABOUT 

Vitaliy N. Katsenelson CFA is Chief Investment Officer at Investment Management Associates in Denver, Colo. He is the author of Active Value Investing (Wiley 2007) and The Little Book of Sideways Markets (Wiley, 2010).  His books were translated into eight languages.  Forbes Magazine called him “The new Benjamin Graham”.  

Assessment

Your thoughts and comments on this ME-P are appreciated.

Conclusion

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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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

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“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

***

 

Can the EHR Save Private Practice?

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OR … Can Private Practitioners Save the EHR? 

By http://www.Kareo.com

***

Kareo EHR Savior

Click to access Kareo_Private_Practice_EHR_Infographic.pdf

[Click Link to Enlarge and Expand]

***

Channel Surfing

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register.

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

More:

  1. The Percentage of Office-Based Doctors with EHRs
  2. Do Nurses like EHRs?
  3. EHRs – Still Not Ready For Prime Time
  4. The “Price” of eHRs

Assessment

Has the “tide-turned”, and physician sentiment changed, since creation of this info-graphic?

Conclusion

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Sponsors Welcomed

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Compensation Trends for Allied Healthcare Professionals

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Beyond Physician Salary [Average by Position]

By http://www.MCOL.com

***

Compensation

***

More:

  1. Doctor Salary v. Others [Present Value of Career Wealth]
  2. The 2015 Physician Pay Check-Up

***

coders

***

Conclusion

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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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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™

“I have read these texts and used consulting services from the Institute of Medical Business of Advisors, Inc. on several occasions.”
Dr. Marsha Lee DO [Radiologists, Norcross, Georgia, USA]

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Frankly Speaking on Patient Safety

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First, do no harm

By Frank Phillips

This phrase is a cherished one throughout healthcare, and a principle by which healthcare facilities and providers alike always seek to abide.

So, in 1999, when the Institute of Medicine published their now famous “To Err is Human” report, individuals and organizations both inside and outside of healthcare were shocked by the findings that an estimated 98,000 people a year die due to mistakes in hospitals. In the years since that report, much has changed in healthcare, but what about patient safety?

What is the scope of the problem, what progress has been made and what are the solutions? Take a look.

***Frankly Speaking

***

Conclusion

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      Product DetailsProduct DetailsProduct Details

***

Understanding the Psychology of [Medical] Data Analytics

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Right with People

Gary Jackson

By Gary Jackson

[Psychology of the Analytics Dilemma]

What if analytical models would have predicted that same sex marriages were going to be legal in the United States by 2015 way back in 1995?

  • Would the concept have been accepted earlier?
  • Debated earlier?
  • Viewpoints changed?

Assessment

Probably not!

The Psychology of Analytics – Right with People

***

Analytics

***

More:

Even More:

Much More:

About Gary Jackson

Gary Jackson is technologist, a host of a podcast called bigdatastupid.com and a Writer for icrunchdata News Hong Kong, China.

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:

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™

“The Certified Medical Planner™ professional designation and education program was created by the Institute of Medical Business Advisors Inc., and Dr. David Edward Marcinko and his team (who wrote this book). It is intended for financial advisors who aim specifically to serve physicians and the medical community.

Content focuses not only on the insurance and professional liability issues relevant to physicians, but also provides an understanding of the risky business of medical practice so advisors can help work more successfully with their doctor-clients.”

Michael E. Kitces, MSFS, MTAX, CFP®, CLU, ChFC, RHU, REBC, CASL

[www.Kitecs.com, Reston, Virginia, USA]

http://www.CertifiedMedicalPlanner.org

***

How Rich – Got Rich?

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Are You Listening – Doctors?

By Rick Kahler MS CFP® http://www.KahlerFinancial.com

Rick Kahler MS CFPAsk ten people how the rich got rich and you will get at least ten opinions.

Some of the more common assumptions are that people become wealthy by inheriting fortunes, taking advantage of those less fortunate, or “playing” the stock market. I even remember one government employee who insisted anyone who obtained wealth had to do so illegally.

While a few people become rich in these ways, they are the exception rather than the rule. A survey by the Spectrem Group asked 132,000 people with a net worth of over $25 million where their wealth came from.

Here are the results: 

  1. Hard Work, 87%. The majority obtained their wealth by working hard. Most millionaires put in long hours, often in careers they love enough so that work becomes play.
  2. Education, 78%. Certainly, people with college educations earn more than those without. However, the right type of education for building wealth may not be found in a college curriculum. For example, I know one person with no college degree who took the equivalent of 75 credit hours of real estate education and amassed large real estate holdings.
  3. Smart Investing, 72%. Don’t confuse smart investing with sophisticated investments. It’s just not that hard to invest smartly: start young, invest regularly, don’t speculate, diversify your investments over multiple asset classes and multiple securities, reduce fees and minimize taxes, and don’t time the markets.
  4. Taking Risks, 63%. I would add, “smart risks.” Actions like starting a business, buying into the company you work for, relocating your family to a city with brighter prospects, changing careers, or borrowing to purchase investment real estate all carry with them a certain degree of risk. And with risk inevitably comes failure. In The Millionaire Next Door, Thomas J. Stanley and William D. Danko point out that the average millionaire makes 3.1 major financial, career, or business mishaps in a lifetime, while the average non-millionaire makes 1.6 such mistakes.
  5. Frugality, 59%. I’ve often called this the common denominator of people that have wealth. My guess is that it didn’t rank higher only because many wealth builders don’t view themselves as frugal. They tend to not have written budgets, they don’t shop at thrift stores, they buy name brands, and they spend everything in their checking account. But what they forget is that they pay themselves first, which includes paying all their bills and taxes, spending heavily for education, and investing 20 to 50% of their paycheck. Then they blow what’s left. I call that frugality.
  6. Being in the Right Place at the Right Time, 56%; and
  7. Luck, 53%. Of course circumstances and luck—factors like timing, knowing people who can help you, and being blessed with abilities and good health—play roles in building wealth. What also matters, however, is being prepared to take advantage of favorable circumstances.
  8. Running a Business, 46%. This fits closely with reason number one: working hard. When you work hard and take smart risks in your own business, or medical practice, you go beyond earning a substantial salary. You build a valuable asset.
  9. Guidance of an Adviser, 35%. Part of reason number three, smart investing, is being smart enough to learn from skilled mentors and advisors.
  10.  Inheritance, 30%. Yes, inheritance is one source of wealth. I’d suggest that most of the inheritors who are able to keep and build on that wealth do so because of factors like hard work, education, and smart investing.

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Niche

[Not for Everyone]

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Assessment

It appears that success in building wealth is similar to success in other areas: the harder and smarter you work, the more success you are likely to have. 

More: The “Rich Doctor” Myth

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:

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

Front Matter with Foreword by Jason Dyken MD MBA

This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs.

It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional.

Parin Khotari MBA

[Whitman School of Management, Syracuse University, New York]

http://www.CertifiedMedicalPlanner.org

***

Doubling the S&P 500‏

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On the Stock-Splits Newsletter

[By Neil Macneale] http://www.2for1Index.com or http://www.USCFAdvisers.com

nmacnealeJust wanted to say hello!

Many who subscribe, or read this ME-P, are personal friends or subscribers to our 2 for 1 newsletter. Others have connected to me one way or the other, such as on LinkedIn.

You may not be aware of the recent events concerning the 2 for 1 Index® and the 2 for 1® newsletter.

As of 7/31/15, the index has doubled the gain of the S&P 500 over the trailing 12 months. That’s +19% vs +9% since 7/31/2014, a great showing in a rather jittery market.

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stock splits

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Assessment

The 2 for 1 Index (NYSE: SPLITS) is comprised of approximately 30 companies which trade on major US stock exchanges. Companies eligible for inclusion have all announced a stock split within the 6 months prior to selection for the Index.  Each month, the 2 for 1 Index is updated on the Friday closest to the 15th of that month. The pool of eligible companies is evaluated and ranked according to a proprietary methodology, and the top ranked candidate is selected for the Index. Sector and market-cap diversification is considered in the selection algorithm. One new stock is added to the Index, and one of the oldest stocks is removed. All positions are rebalanced to equal weight.

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:

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

Front Matter with Foreword by Jason Dyken MD MBA

logos

“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

***

Happy Birthday Irene Bergman [A 99-year-old financial advisor]

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Happy Birthday – Ring that NYSE Bell

[By staff reporters]

A 99-year-old financial advisor and holocaust survivor will be the oldest person to ring to the bell at the New York Stock Exchange in honor of her 100th birthday; today August. 2nd, 2015.

As a teen, Irene Bergman wanted to follow her private banker father to the Berlin stock exchange, but the Nazis chased them out of Europe in 1942. Now she is a financial advisor at Stralem & Co., overseeing institutional and individual clients, which she advises from her midtown apartment decorated with paintings from Dutch masters and pre-war European furniture.

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stock-exchange-

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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:

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

“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

National Mega Health Plans

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Membership Top 10 Largest Plans

By http://www.MCOL.com

ImageProxy

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:

[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

Product DetailsProduct DetailsProduct Details

[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD] 

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