IADLs: Instrumental Activities of Daily Living

DEFINITIONS

By Staff Reporters

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Instrumental Activities of Daily Living (IADLs)

According to Leslie Kernisan MD MPH, these are the basic self-care tasks that we initially learn as very young children. These are the self-care tasks we then learn as teenagers. They require more complex thinking skills, including organizational skills. They include:

  • Managing finances, such as paying bills and managing financial assets.
  • Managing transportation, either via driving or by organizing other means of transport.
  • Shopping and meal preparation. This covers everything required to get a meal on the table. It also covers shopping for clothing and other items required for daily life.
  • Housecleaning and home maintenance. This means cleaning kitchens after eating, keeping one’s living space reasonably clean and tidy, and keeping up with home maintenance.
  • Managing communication, such as the telephone and mail.
  • Managing medications, which covers obtaining medications and taking them as directed.

Because managing IADLs requires a fair amount of cognitive skill, it’s common for IADLs to be affected when an older person is having difficulty with memory or thinking. For those older adults who develop Alzheimer’s disease or a related dementia, IADLs will usually be affected before ADLs are.

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IADLs were defined about ten years after ADLs, by a psychologist named M.P. Lawton. Dr. Lawton felt there were more skills required to maintain independence than were listed on the original Katz ADL index, and hence created the “Lawton Instrumental Activities of Daily Living Scale.”

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DAILY UPDATE: Stock Markets Surge!

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Nvidia: Worth 4-trillion dollars.

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Stocks up

  • Hims & Hers Health gained 4.62% after announcing it will sell generic semaglutide in Canada when Novo Nordisk’s patent for Ozempic and Wegovy expires in January.
  • Merck shareholders applauded its move to buy respiratory drugmaker Verona Pharma for $10 billion, sending its stock up 2.88%.
  • Rhythm Pharmaceuticals popped 36.63% thanks to a promising new trial for its oral obesity treatment.
  • AES, a renewable power company that counts Microsoft among its clients, jumped 19.87% after Bloomberg reported it was considering a sale.
  • Fashion names Ralph Lauren (+2.10%) and Coach owner Tapestry (+3.31%) hit record highs.

Stocks down

  • WPP cut its guidance and watched its stock fall 18.11% as a result. The ad giant is dealing with a laundry list of challenges, from AI disrupting the industry to clients spending less to finding a new CEO.
  • Medical device maker RxSight plunged 37.84% after slashing its full-year revenue forecast.
  • T-Mobile ticked 1.55% lower after getting a downgrade from KeyBanc, which said its weakness in fiber internet would prevent it from catching up to rival AT&T.
  • Mobileye, which makes self-driving tech and was spun out of Intel, fell 7.08% when Intel said it was selling 45 million shares.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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Bonds, Socks and Nvidia

By A.I.

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  • Stocks: The major indexes plowed higher with the minutes of the last FOMC meeting showing that officials were not at all united about when to begin cutting rates. Investors also treated more tariff letters sent by President Trump to seven more countries including Iraq and the Philippines as not vital.
  • Bonds: US Treasuries snapped a five-day losing streak after a $39 billion sale of 1-year notes was met with solid demand.
  • Nvidia: Worth 4-trillion dollars.

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Gerontologist V. Geriatrician?

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VILLAGES HEALTH SYSTEM: Files Chapter 11 Bankruptcy

By A.I.

BREAKING NEWS!

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The Villages Health System, LLC, a health care provider operating in The Villages, Florida, filed for Chapter 11 bankruptcy protection on July 3rd, 2025, in the United States Bankruptcy Court for the Middle District of Florida.

“The bankruptcy petition indicates significant financial challenges, with assets estimated between $50 million and $100 million and liabilities between $100 million and $500 million. The United States of America is listed as the largest creditor with a contingent, unliquidated claim of approximately $361 million. The filing indicates that funds will be available for distribution to unsecured creditors,”

RK Consultants reported on X, the former Twitter. 

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DAILY UPDATE: Women’s Health, and Commodities, as Stock Markets Struggle

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Record VC investments for women’s health: Venture-backed women’s health startups experienced unprecedented investment last year, according to a new SVB report. The report examines the factors driving such record-breaking funding—like growing recognition of how various health conditions affect women differently and disproportionately, plus the causes and biological drivers behind this imbalance. Read it here.

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  • Stocks: Investors mostly yawned and the major indexes held steady a day after President Trump reignited his trade war by announcing higher tariffs would go into effect on 14 countries starting August 1st. Wall Street banks don’t seem concerned either, as Goldman Sachs and Bank of America became the latest strategists to raise their year-end target for the S&P 500.
  • Commodities: Copper futures popped as much as 17% to a new record, the largest intra-day gain since at least 1988, after Trump said he plans to place a 50% tariff on copper imports.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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ADLs: Activities of Daily Living

DEFINITIONS

By Staff Reporters

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Activities of Daily Living (ADLs)

According to Leslie Kernisan MD MPH, these are the basic self-care tasks that we initially learn as very young children. They are sometimes referred to as “Basic Activities of Daily Living” (BADLs). They include:

  • Walking, or otherwise getting around the home or outside. The technical term for this is “ambulating.”
  • Feeding, as in being able to get food from a plate into one’s mouth.
  • Dressing and grooming, as in selecting clothes, putting them on, and adequately managing one’s personal appearance.
  • Toileting, which means getting to and from the toilet, using it appropriately, and cleaning oneself.
  • Bathing, which means washing one’s face and body in the bath or shower.
  • Transferring, which means being able to move from one body position to another. This includes being able to move from a bed to a chair, or into a wheelchair. This can also include the ability to stand up from a bed or chair in order to grasp a walker or other assistive device.

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If a person is not fully independent with ADLs, then we usually include some information about the amount of assistance they require. ADLs were originally defined in the 1950s by a geriatrician named Sidney Katz, who was trying to define what it might look like for a person to recover to independence after a disabling event such as a stroke or hip fracture. So these measures are sometimes called the “Katz Index of Independence in Activities of Daily Living.”

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DAILY UPDATE: FBI and FDA as Stock Markets Crash

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  • The FBI has uncovered $14.6 billion worth of fraudulent claims submitted to Medicare, Medicaid and other government health care programs, the agency said on Monday in conjunction with the Department of Justice (DOJ). The investigation resulted in 324 defendants being charged, including 96 medical professionals.
  • Now, the DOJ, FBI and HHS say they are collaborating to create a health care data fusion center that will help them identify, investigate and prosecute health care fraud.
  • And yesterday, the entities announced a DOJ-HHS False Claims Act Working Group, in which HHS will refer potential False Claims Act violations to the DOJ. Read more about the working group, its members and its goals here.

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Stocks: US equities tumbled from record highs, dragged down by megacaps, as President Trump reignited the dormant trade war with fresh tariff warnings against major trading partners (more on that in a sec). Meanwhile, the dollar bounced 0.5% against a basket of other currencies.

Commodities: Oil gained despite OPEC+ deciding to raise crude production by 548,000 barrels per day beginning in August, a larger-than-expected increase. Ultimately, Wall Street analysts expect oil futures to drop below $60 a barrel by the end of the year due to the increase in production.

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Read: FDA Commissioner Marty Makary MD is revamping the agency, with plans to use more AI assistance. (the Wall Street Journal)

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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ELDER ABUSE: Financial Exploitation Protection

By Rick Kahler CFP

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One serious risk to financial wellbeing in retirement that is difficult to talk about is financial exploitation. Someone whose cognitive abilities are declining is vulnerable to harm from both financial predators and their own financial misjudgments. Protecting such clients is a crucial part of a financial advisor’s role.

A little-known but important law, the Senior Safe Act, was enacted in 2018. It encourages financial advisors and institutions to report suspected elder abuse by offering immunity from legal liability when reports are made in good faith and with reasonable care. To qualify for these protections, financial professionals must undergo annual training to recognize the signs of exploitation and know how to act on their suspicions.

In many ways, the Senior Safe Act mirrors the duty of therapists to report when clients are threats to themselves, such as when a client becomes suicidal. Just as a therapist must balance confidentiality with the moral and legal responsibility to protect their client from harm, a financial advisor must weigh privacy against the need to prevent financial exploitation. Both roles rely on professional judgment, training, and the courage to act when the stakes are high.

Financial advisors, accountants, and attorneys are often the first to notice troubling signs that someone is being taken advantage of financially. These might include sudden large withdrawals, changes to account ownership or beneficiaries, or a newly and overly involved friend or family member. Behavioral shifts like confusion, anxiousness, secretiveness, or uncharacteristic deference are also red flags. These patterns are unsettling and demand attention, even when stepping in is uncomfortable.

Reporting possible elder abuse isn’t always straightforward, especially if the suspected abuser is a family member. As an advisor, I worry about misunderstandings, potential conflicts with the family, and even the possibility of damaging a relationship with the client. None of this is easy, But when the signs of exploitation become clear, staying silent could mean allowing harm to continue. That’s a risk I can’t take.

One of the tools I started using decades ago is the trusted contact disclosure form. This simple but powerful document allows clients to name someone my firm can contact if they notice unusual activity, such as a suspicious withdrawal or transfer. The trusted contact does not have control over the client’s account but serves as a resource to verify their well-being and ensure that their financial decisions align with their long-term goals. If you as a client have not signed such a form, it’s worth discussing with your advisor as a preventative step.

If you are concerned about the financial well-being of an elderly loved one, it’s crucial to alert not only their financial advisor but also other professionals like accountants, attorneys, or bankers. These professionals may have insights or access to information you don’t have, and by sharing your concerns, you provide a broader picture that can help them detect and address issues more effectively. Even if they are already monitoring for red flags, your input can provide valuable context to guide their next steps.

Difficult though it may be, stepping into uncomfortable territory is often essential to protecting vulnerable individuals. Whether it’s a financial advisor detecting exploitation or a therapist intervening in a mental health crisis, the goal is the same—to prevent harm while respecting the person’s autonomy.

The Senior Safe Act is a reminder that sometimes the most impactful safeguards work quietly behind the scenes. Taking simple steps like completing a trusted contact form or encouraging your loved one to work with a reputable, fiduciary advisor can make all the difference. Vigilance is an act of care that helps protect someone’s financial assets as well as their dignity and well-being.

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BRAND MANAGEMENT: 7 Approaches For Doctors and Financial Advisors

By A.I.

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Any extensive analysis of numerous papers published on brand management leads to the seven approaches mentioned below. This included 300+ articles from Journal of Marketing, Journal of Marketing Research, Journal of Consumer Research, Harvard Business Review and European Journal of Marketing.

So, it can be safe to claim that no matter which framework or model one follows it must have originated via one of the seven approaches listed below.

The Seven Branding Approaches are:

  • The economic approach: the brand as part of the traditional marketing mix.
  • The identity approach: the brand as linked to corporate identity.
  • The consumer-based approach: the brand as linked to consumer associations.
  • The personality approach: the brand as a human-like character.
  • The relational approach: the brand as a viable relationship partner.
  • The community approach: the brand as the pivotal point of social interaction.
  • The cultural approach: the brand as part of the broader cultural fabric.

There are multiple theories and model to be followed in the area of brand management with their own school of thought and have been proven to work.

These include the Aaker’s brand identity model, Kapferer’s brand prism or Keller’s customer-based brand equity pyramid. All of them will enhance the brand equity of the product or service but may have evolved from different school of thoughts. Though everyone talks about the different models, rarely we find text on the school of thought rather then the actual model in practice.

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And, you will find the Brand Asset Valuator Model in many books but you might never come to know the author’s perspective.

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OREGON BANS: Corporate Control of Physicians

By Health Capital Consultants LLC

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On June 9th, 2025, Oregon’s governor signed into law the country’s strictest corporate practice of medicine (CPOM) prohibition. Senate Bill (SB) 951 will severely curtail the involvement of private equity firms and other corporations in the state’s medical practices.

This Health Capital Topics reviews the bill and discusses the implications on the healthcare industry. (Read more…)

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DOCTOR BRANDING STRATEGIES: Exploring 9 [NINE] Different Types

By A.I.

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Medical doctors, dentists, and podiatrists have to undergo extensive training before they can practice medicine independently. Once they receive training, there are opportunities to increase pay and prestige in the medical field through a series of promotions. As a doctor, how much training, experience and skills you have can determine your ability to move upward in these levels. But, personal branding strategies may even be more vital in today’s social media age?

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Physician, medical and healthcare branding is more than just the creation of logos, taglines, or specific brand messaging. It’s about creating a meaningful connection between your mission, vision and values and the people served – from patients and their families to local and global communities.

While there are many different types of branding strategies in marketing science, they all share key elements that serve as the foundation for the strategy. These 9 elements for all physicians and medical professionals include the following:

  1. Brand purpose: The reason the physician is in practice and what he/she is trying to achieve.
  2. Brand vision: The ideas and goals behind the dentist which serve as inspiration for practice growth.
  3. Brand values: The osteopaths beliefs and what they stand for.
  4. Target audience: The demographic(s) and patient targets that the podiatrist is aiming to reach.
  5. Market analysis: An analysis of the marketplace that identifies gaps where the chiropractor has an opportunity to position him/her self based on a unique value proposition.
  6. Awareness goals: The initiatives the doctor will take in order to reach a target market patient demographic.
  7. Brand personality: The human-like attributes of the physician that will help build relationships with patients, consumers and other physicians and practitioners.
  8. Brand voice: The language and tone the doctor uses to communicate with patients, physicians and consumers.
  9. Brand tagline: A memorable slogan that sums up the physician and their medical offering in a few choice words.

And so, physician branding is the development of a easily recognizable identity for a medical practice, clinic or healthcare organization that helps to shape perception by current and prospective patients and the wider world.

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UNHAPPY HOSPITALS: One Big Beautiful Bill Act!

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One Big Beautiful Bill Act (OBBBA; OBBB; BBB), or the Big Beautiful Bill, is a budget reconciliation bill in the 119th US Congress.

Hospitals are not happy with the health care provisions of the bill, which would reduce the support they receive from states to care for Medicaid enrollees and leave them with more uncompensated care costs for treating uninsured patients.

“The real-life consequences of these nearly $1 trillion in Medicaid cuts – the largest ever proposed by Congress – will result in irreparable harm to our health care system, reducing access to care for all Americans and severely undermining the ability of hospitals and health systems to care for our most vulnerable patients,” said Rick Pollack, CEO of the American Hospital Association.

The association said it is “deeply disappointed” with the bill, even though it contains a $50 billion fund to help rural hospitals contend with the Medicaid cuts, which hospitals say is not nearly enough to make up for the shortfall.

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BEWARE: July Fourth Fireworks PLUS Helpful Weekend Reading List

By Dr. David Edward Marcinko MBA MEd

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Happy Fourth of July! It’s a good day to avoid the emergency department, so leave the fireworks shows to the pros—and perhaps use your extra hands to double-fist some BBQ instead.

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WEEKEND READING LIST: EDUCATION: Books

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DAILY UPDATE: OpenAI & Microsoft as Stock Markets Surge

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OpenAI is giving its employees a mandatory week long vacation to stave off a poaching spree launched by Meta.

Microsoft announced another round of layoffs—its largest in years—expected to impact thousands of workers across Xbox and other divisions, including 830 from its Redmond, Washington, HQ.

CITE: https://tinyurl.com/2h47urt5

The S&P 500 and NASDAQ Composite tallied fresh record closing highs on Thursday, buoyed by a stronger-than-expected jobs report that helped dampen expectations for a Federal Reserve interest-rate cut in July. But after lagging their trendier rivals earlier in the year, the Russell 2000 and Dow Jones Industrial Average are finally starting to play catch up. On Thursday, the Russell 2000 turned positive for 2025 for the first time since February, as a rally that started in June has accelerated in July.

Many investors have been waiting patiently for small-cap stocks to break out. But aside from a few false starts over the past two years, they have mostly continued to lag their large-cap rivals. However, some investors believe things could finally be changing.

A team of strategists at Barclays pointed out on Wednesday that a proposed increase to interest-expense tax deductions in President Trump’s budget bill could boost small-cap companies’ earnings by double digits, due to their higher interest burdens. “This market broadening out is a heathy sign,” said Craig Johnson, chief market technician at Piper Sandler, during an interview with MarketWatch on Thursday. More small-cap participation inevitably means investors are developing more of a taste for stocks beyond information technology, which powered much of the market’s gains in 2023 and 2024.

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Friday, July 4, 2025

  • All U.S. markets will be closed in observance of Independence Day.
  • There will be no Pre-Market or After-Hours trading sessions.

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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Stocks, Bonds & Commodities

By A.I.

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BRANDS & BRAND MANAGEMENT: Defined and Explored for Doctors and Advisors

By A.I.

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What Is a Marketing Brand

A brand is a name, term, design, symbol or any other feature that distinguishes one seller’s goods or service from those of other sellers. Brands are used in business, marketing and advertising for recognition and, importantly, to create and store value as brand equity for the object identified, to the benefit of the brand’s clients, patients, customers, its owners and shareholders. Brand names are sometimes distinguished from generic or store brands.

BRANDING: https://medicalexecutivepost.com/2023/02/02/podcast-personal-branding-for-doctors/

What is Brand Management?

Brand management, also known as Marketing, is responsible for the overall management of a brand. This includes everything from product or service development and marketing to advertising and public relations. All of these aspects work together to create a particular image or reputation for a brand. The goal of brand management is to create a robust and positive reputation for a brand that will result in increased sales and market share.This process helps companies create a unique identity for their products or services in the marketplace. A successful brand management strategy can build client, patient and customer loyalty .

BRANDS: https://medicalexecutivepost.com/2021/06/03/physician-branding-post-pandemic/

Branding is essential for financial advisors, doctors and businesses because it involves creating a unique identity for a company’s products, offerings and services. It can also help build customer, client and patient loyalty and emotionally connect with the practitioner. Branding can be complex, but it is essential to understand the basics before starting a brand strategy.

Thus, doctors, podiatrists, dentists, CPAs, insurance agents, financial advisors and their practices need to understand the different aspects of branding and brand management to create a strong brand identity.

SELF BRANDING: https://medicalexecutivepost.com/wp-content/uploads/2011/03/leadership-self-branding-marcinko.pdf

EDUCATION: Books

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JULY FOURTH: The Business Side

By InfoGraphics

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DAILY UPDATE: Human Genome Project as the Dow and NASDAQ Diverge

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When it comes to scientific achievements that have advanced the practice of medicine, you’d be hard-pressed to find one more influential than the Human Genome Project. The project, a federally funded collaboration between scientists around the globe, began in October 1990 with the goal of improving our knowledge of human biology by sequencing an entire human genome, which is the complete set of DNA in a cell. Nearly 13 years and $2.7 billion later, the project wrapped up in April 2003, and scientists around the world now use the reference human genome to study genetics, biology, and more. Today, the entire human genome can be sequenced in as little as five hours and costs as little as $600. Learn more about the Human Genome Project’s impact here.

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🟢 What’s up

  • Jack in the Box popped like a…well, you know…after activist investor Biglari Capital reportedly accrued a 10% stake in the fast-food company. Shares rose 7.86%.
  • Robinhood Markets climbed 6.12% on speculation that it may be added to the S&P 500 to fill the spot left by Juniper Networks.
  • Rigetti Computing rose 15.45% after Cantor Fitzgerald analysts initiated their coverage of the quantum computing company with an “overweight” rating.
  • Verint Systems jumped 15.33% on reports that the customer service software maker may be acquired by Thoma Bravo.
  • Corona parent company Constellation Brands gained 4.48% after it reiterated its fiscal guidance, assuring shareholders that aluminum tariffs will only cost the company about $20 million.
  • Crypto companies gained across the board after bitcoin miner BitMine Immersion Technologies announced it’s pivoting to ethereum. BitMine rose 21.17%, MARA Holdings gained 13.38%, and CleanSpark climbed 12.64%.

What’s down

  • Centene plunged 40.37% after the health insurer rescinded its fiscal 2025 guidance, warning that EPS will come in lower than anticipated.
  • Centene’s news pulled the rest of the health insurance industry down with it. UnitedHealth Group lost 5.70%, CVS Health fell 4.28%, Elevance Health stumbled 11.50%, and Molina Healthcare dropped 21.97%.
  • Paramount Global sank 2.43% after the company settled its 60 Minutes lawsuit with President Trump for $16 million.
  • Marvell Technology slipped 2.61% on reports that Microsoft is cutting back on manufacturing AI chips in-house.
  • Intel lost 4.25% on the news that it may be shifting the strategy behind its foundry business.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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Stocks, Bonds & Commodities

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BEWARE FIREWORKS: Money to Burn on the Fourth of July

The Complete Guide to July 4th Fireworks

Gather your novelty flag apparel and preheat your grills: Independence Day 2024 is upon us. And, what’s a July 4th celebration without some explosions in the sky?

Assessment

This info-graphic takes a closer look at the less glamorous side of fireworks — from the dollars that go up in smoke to the fingers we burn.

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[via MedPub]

Happy Fourth ME-P readers; please light responsibly!

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DAILY UPDATE: Crude Oil Prices Reverse as Stock Markets Diverge

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

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Power station: Crude oil prices reversed as tensions in the Middle East cooled, but AI likely raises electricity demand over the longer term, creating investment opportunities and risks.

Oil supplies now exceed demand, noted Michelle Gibley, director of international research at the Schwab Center for Financial Research, in her latest analysis, though “AI is transforming the energy sector,” raising power shortage concerns.

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🟢 What’s up

  • Solar stocks got a reprieve today after the Senate dropped the excise tax on clean energy projects. Sunrun soared 10.51%, Enphase Energy rose 3.18%, SolarEdge Technologies popped 7.16%, and Array Technologies climbed 12.54%.
  • Apple tumbled this summer after investors were disappointed by its AI rollout, but rose 1.29% on the news that the company may pivot to using Anthropic or OpenAI in iPhones instead of building something in-house.
  • Wolfspeed, the best name for a company that makes computer chips, exploded 98.09% after the company officially filed for Chapter 11 bankruptcy.
  • Hasbro got a nice 4.29% bump thanks to Goldman Sachs analysts, who are big old nerds who think Magic: The Gathering will boost the toymaker’s sales.
  • Ford popped 4.61% after the automaker reported an impressive 14% increase in sales last quarter.
  • Casino stocks soared on the news that gaming revenue in Macau rose 19% in June. Wynn Resorts climbed 8.85%, Las Vegas Sands added 8.95%, and MGM Resorts gained 7.24%.

What’s down

  • AMC Entertainment tumbled 9.03% after the one-time meme stock announced its new debt restructuring plan.
  • Progress Software sank 13.03% after the business application software company reported mixed results last quarter, beating on profit but missing on revenue.
  • Joby Aviation fell 7.01% after traders took profits following the air taxi company’s big pop yesterday.
  • AeroVironment dropped 11.42% after defense contractor announced it’s offering $750 million in common stock and $600 million in convertible senior notes to pay off its debt.
  • Diabetes device makers tumbled on the news that the government may change the reimbursement rate for glucose monitors and insulin pumps. Insulet lost 4.52%, Dexcom fell 4.25%, and Beta Bionics sank 4.26%.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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Stocks, Bonds and Safe Havens

By A.I.

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Financial Monte Carlo Simulation’s FLAW and FIXES

Physicians Must Understand Deus ex Machina

[By Wayne J. Firebaugh Jr; CPA, CFP®, CMP™]

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wayne-firebaughNamed after Monte Carlo, Monaco, which is famous for its games of chance, MCS is a software technique that randomly changes a variable over numerous iterations in order to simulate an outcome and develop a probability forecast of successfully achieving an outcome.

Endowment Fund Perspective

In private portfolio and fund endowment management, MCS is used to demonstrate the probability of “success” as defined by achieving the endowment’s asset growth and payout goals. In other words, MCS can provide the endowment manager with a comfort level that a given payout policy and asset allocation success will not deplete the real value of the endowment.

Divorce from Judgment

The problem with many quantitative software and other tools is the divorce of judgment from their use. Although useful, both mean variance optimization MVO and MCS have limitations that make it so they should not supplant the physician investor or endowment manager’s experience. MVO generates an efficient frontier by relying upon several inputs: expected return, expected volatility, and correlation coefficients. These variables are commonly input using historical measures as proxies for estimated future performance. This poses a variety of problems.

Problems with MCS 

First, the MVO will generally assume that returns are normally distributed and that this distribution is stationary. As such, asset classes with high historical returns are assumed to have high future returns.

Second, an MVO optimizer is not generally time sensitive. In other words, the optimizer may ignore current environmental conditions that would cause a secular shift in a given asset class returns.

Finally, an MVO optimizer may be subject to selection bias for certain asset classes. For example, private equity firms that fail will no longer report results and will be eliminated from the index used to provide the optimizer’s historical data [1].

Example:

As an example, David Loeper, CEO of Wealthcare Capital Management, made the following observation regarding optimization:

Take a small cap “bet” for our theoretical [endowment] with an S&P 500 investment policy. It is hard to imagine that someone in 1979, looking at a 9% small cap stock return premium and corresponding 14% higher standard deviation for the last twenty years, would forecast the relationship over the next twenty years to shift to small caps under-performing large caps by nearly 2% and their standard deviation being less than 2% higher than the 20-year standard deviation of large caps in 1979 [2].

Table: Compares the returns, standard deviations for large and small cap stocks for the 20-year periods ended in 1979 and 1999.  Twenty Year Risk & Return Small Cap vs. Large Cap (Ibbotson Data).

1979 1999
Risk Return Correlation Risk Return Correlation
Small Cap Stocks 30.8% 17.4% 78.0% 18.1% 16.9% 59.0%
Large Cap Stocks 16.5% 8.1% 13.1% 18.6%

*Reproduced from “Asset Allocation Math, Methods and Mistakes.” Wealthcare Capital Management White Paper, David B. Loeper, CIMA, CIMC (June 2, 2001).

More Problems with MCS

David Nawrocki identified a number of problems with typical MCS as being that most optimizers assume “normal distributions and correlation coefficients of zero, neither of which are typical in the world of financial markets.”

Dr. Nawrocki subsequently describes a number of other issues with MCS including nonstationary distributions and nonlinear correlations.

Finally, Dr. Nawrocki quotes Harold Evensky who eloquently notes that “[t]he problem is the confusion of risk with uncertainty.

Risk assumes knowledge of the distribution of future outcomes (i.e., the input to the Monte Carlo simulation).

Uncertainty or ambiguity describes a world (our world) in which the shape and location of the distribution is open to question.

Contrary to academic orthodoxy, the distribution of U.S. stock market returns is far from “normal”. Other critics have noted that many MCS simulators do not run enough iterations to provide a meaningful probability analysis.

Assessment 

Some of these criticisms have been addressed by using MCS simulators with more robust correlation assumptions and with a greater number of iterative trials. In addition, some simulators now combine MVO and MCS to determine probabilities along the efficient frontier.

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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References:

1. Clark, S.E. and Yates, T.T., Jr. “How Efficient is your Frontier?” Commonfund Institute White Paper (November 2003).

2. Loeper, D.B., CIMA, CIMC. “Asset Allocation Math, Methods, and Mistakes.” Wealthcare Capital Management White Paper (June 2001).

3. Nawrocki, D., Ph.D. “The Problems with Monte Carlo Simulation.” FPA Journal (November 2001).

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Liberation Day Comeback

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The S&P 500 closed within a hair of a new record yesterday marking an enormous comeback that followed the April announcement of “Liberation Day” tariffs.

Despite a persistent vibe of uncertainty related to US economic policy and geopolitics:

  • The S&P 500 closed less than 0.1% away from a record high which it notched in February before cratering nearly 20% in April. The index has regained ground in fits and starts since then and briefly surpassed its record in intra-day trading yesterday.
  • On Monday, the tech-heavy NASDAQ 100 one-upped the broader market and logged its highest-ever close. It came after President Trump said Israel and Iran agreed to a ceasefire, which eased investors’ concerns about a potential oil crisis.

According to Morning Brew, between unresolved geopolitical conflicts and President Trump’s still-unfolding tariff policies, a portfolio manager with Capital Wealth Planning, Kevin Simpson, told CNBC that he was “surprised by the magnitude of the rebound.”

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DAILY UPDATE: 23andMe as Stock Markets Rise

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SPONSORED BY: Marcinko & Associates, Inc.

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Stat: $305 million. That’s how much 23andMe co-founder and former CEO Anne Wojcicki’s nonprofit paid to acquire the genetics company. (CNN)

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What’s up

  • Building products distributor GMS soared 11.73% on the news that Home Depot will acquire the company for $4.3 billion. Home Depot fell 0.50%.
  • Moderna climbed 1.58% after reporting positive late-stage trial results for its experimental flu vaccine.
  • Palantir rose 4.27% after announcing that Accenture will help federal government clients implement the defense tech company’s AI offerings. Accenture rose 1.16% as well.
  • Joby Aviation flew 11.76% higher after the eVTOL company delivered its first flying taxi to the UAE.
  • Oracle jumped 3.99% thanks to regulatory filings that revealed a new $30 billion annual cloud deal that should prop up its finances quite nicely.
  • Hewlett Packard Enterprise popped 11.08% after the Department of Justice settled its lawsuit with the server maker, clearing the way for it to acquire Juniper Networks for $14 billion. Juniper jumped 8.45% on the news.
  • Robinhood Markets rose 12.77% as the trading app makes a big international push with tokenized equities for European investors.

What’s down

  • Tesla tumbled 1.84% on the news that the Senate version of the tax bill will end credits for EV purchases after September. Elon Musk was not pleased.
  • Gotta pay for that wedding somehow: Amazon sank 1.75% after founder Jeff Bezos announced he’s selling $5.4 billion worth of shares.
  • Boeing’s financial outlook was upgraded to “stable” by Fitch, but the stock still fell 2.32% on news that its acquisition of Spirit Aerosystems faces antitrust scrutiny in the UK.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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