BIAS: Beware Overconfident Investing

By Staff Reporters and A.I.

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OVERCONFIDENT INVESTING BIAS

Overconfident Investing Bias happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. This causes the results of a study to be unreliable and hard to reproduce in other research settings.

Example: Data convincingly shows that people and financial planners/advisors and wealth managers who trade most often under-perform the market by a significant margin over time. Active traders lose money.

Example: Overconfidence Investing Bias moreover leads to: (1) excessive trading (which in turn results in lower returns due to costs incurred), (2) underestimation of risk (portfolios of decreasing risk were found for single men, married men, married women, and single women), (3) illusion of knowledge (you can get a lot more data nowadays on the internet) and (4) illusion of control (on-line trading).

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Psychiatrist V. Psychologist V. Psychotherapist

DEFINITIONS
By A. I. and Staff Reporters

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The terms “psychologist” and “psychiatrist” are often used interchangeably to describe anyone who provides therapy services, but the two professions and the services they provide differ in terms of content and scope. A major difference between the two types of experts is that psychiatrists can prescribe medication [Rx].

  • As physicians [MD/DO] psychiatrists are trained to recognize the ways biological processes affect mental functioning.
  • Psychologists are oriented to how thoughts, feelings, and social factors influence mental functioning.

PSYCHIATRIST

Psychiatrists are medical or osteopathic doctors who are able to prescribe psychotropic medications, which they do in conjunction with providing psychotherapy though medical and pharmacological interventions are often their focus.

PSYCHOLOGIST

Though many psychologists hold doctorate degrees, they are not medical doctors, and most cannot prescribe medications. Rather, they solely provide psycho-therapy, which may involve cognitive and behavioral interventions, psycho-dynamic or psycho-analytic approaches.

NOTE PROTECTED TITLE: The title of “psychologist” can only be used by an individual who has completed the required education, training, and state license requirements. Informal titles, such as “counselor” or “therapist,” are often used as well. Other mental health care professionals, such as licensed social workers, can claim those titles, but not the title of “psychologist.”

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HEALTH CARE SPENDING: Projected to Exceed $8.5 Trillion by 2033

By Health Capital Consultants LLC

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On June 25th, 2025, the Centers for Medicare & Medicaid Services (CMS) released its forecast on U.S. healthcare spending through 2033. The analysis, published in Health Affairs, estimated healthcare spending growth in 2024 and projected the growth into 2033. CMS found that overall healthcare spending growth has decreased slightly but is still elevated compared to pre-pandemic levels, and is expected to continue to moderately grow.

This Health Capital Topics article examines the factors underlying the forecasts. (Read more…) 

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Bitcoin, Stocks, Oil, Gold and Silver

By A.I.

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  • Stocks: The major Wall Street stock indexes languished. The S&P pulled back from its record high to close the week just a bit lower, but the NASDAQ managed to post a gain across the week.
  • Crypto: Bitcoin hit a new high-water mark above $118,000. Next week, July 14th, Congress hosts “Crypto Week” to discuss regulating the industry in a growth-oriented manner.
  • Commodities: Silver rose to its highest level since 2011, and it’s been even hotter than gold. The metal is up ~27% this year. Oil, meanwhile, ticked higher on speculation that President Trump will place more sanctions on Russia early next week.

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DAILY UPDATE: CVS & Merck as Stock Markets Struggle

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

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CVS has threatened to close 23 pharmacies in Arkansas after the state passed a law banning companies that own pharmacy benefit managers (PBMs) from also operating pharmacies starting in 2026.

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

What’s up stocks

  • Kraft Heinz jumped 2.53% following a WSJ report it was preparing to break itself up (but not back to Kraft and Heinz).
  • Companies in the drone sector rose after the Pentagon introduced measures to supercharge production and deployment. Red Cat rose 26.40%, AeroVironment 11.04%, and Kratos Defense & Security Solutions 11.76%.
  • Performance Food Group jumped 4.84% to a record after reportedly being eyed by US Foods Holding for a takeover. A combined company would become the top foodservice distributor in the US with combined sales of ~$100 billion.
  • AMC Entertainment popped 11% on an upgrade from Wedbush. It’s tired of IMAX hogging the Brew Markets spotlight…

What’s down stocks

  • Delta (-0.23%) and United (-4.34%) took a breather after their big celebration on Thursday post-Delta earnings.
  • Penn Entertainment got hit 7.62% when gaming revenue for Iowa and Indiana came in soft.
  • Sunrun’s up-and-down week ended…down, with the solar stock falling 7%.

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Stat: $10 billion. That’s how much Merck is paying to buy UK-based biopharmaceutical Verona Pharma. (CNBC)

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

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Goldman Sachs and Bitcoin

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By A.I.

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Bitcoin notched another all-time record yesterday, beating the previous record that was set two days ago.

Goldman Sachs plans to ask junior bankers to certify their loyalty every three months in order to prevent poaching by private equity firms, Bloomberg reported.

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DAILY UPDATE: Measles Cases Up as Stock Markets Rise

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Daily Update Provided By Staff Reporters Since 2007.
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© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2025.

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US measles cases have reached a 33-year high. A little more than halfway into 2025, the US has reported 1,288 measles cases, marking the highest yearly total since 1992, according to data from the Centers for Disease Control and Prevention.

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Stocks up

  • Cereal legend WK Kellogg popped 30.57% after chocolate giant Ferrero agreed to acquire it for north of $3 billion.
  • Tesla (+4.73%) continued to rebound from its plunge on Monday. Elon Musk said that Tesla’s robotaxi service would expand into the Bay Area “probably in a month or two” and that his AI chatbot Grok is coming to Tesla vehicles by next week.
  • Estée Lauder gained 6.32% after Bank of America slapped a buy rating on the stock, implying a 27% upside from Wednesday’s closing price. 
  • ProKidney continued its remarkable rally, rising another 19.35%, after the biotech announced positive trial results for its diabetes treatment. It’s gone from a penny stock to a $1.55 billion market cap in the past four days.
  • Copper companies Freeport-McMoRan (+3.51%) and Southern Copper (+2.34%) gained thanks to Trump’s announcement that copper tariffs would begin on August 1.

Stocks down

  • Biotech partners Ultragenyx (-25.11%) and Mereo BioPharma Group (-42.52%) plunged after issuing a disappointing update on their trial of a treatment for a rare genetic bone condition.
  • Vertiv, the maker of liquid cooling equipment, declined 5.96% when Amazon said it was rolling out a new liquid cooling system for its AI servers.
  • Hydro Flask owner Helen of Troy tumbled 22.71% after reporting a $450 million loss in its fiscal first quarter. CEO Brian Grass said “tariff-related impacts” were its Achilles heel.
  • Autodesk fell 6.89% after Bloomberg reported on Wednesday it was weighing a takeover of rival engineering software company PTC.

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

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Stocks, Commodities and Crypto-Currency

By A.I.

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  • Stocks: Jobless claims came in lower than expected, the 30-year US bond auction met with strong demand, and Delta Airlines unofficially kicking off earnings season with a solid report. The S&P 500 and the NASDAQ hit record highs.
  • Crypto: Bitcoin reached a record high for the second day in a row, hitting $113,863.31 today. The crypto’s price has stayed above $100k for 60 consecutive days.
  • Commodities: Coffee futures in New York climbed as much as 3.5% in response to President Trump’s threat to slap 50% tariffs on Brazil, which is the top producer of higher-end arabica coffee.

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What is a “Market-Neutral” Fund?

Market Neutral Funds Demystified

[A Special Report]

By Dimitri Sogoloff MD MBA & Dr. David E. Marcinko MBA MEd CMP

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Introduction

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It’s hard to believe that just 30 years ago, physician investors had only two primary asset classes from which to choose: U.S. equities and U.S. bonds.

Today, the marketplace offers a daunting array of investment choices. Rapid market globalization, technology advancements and investor sophistication have spawned a host of new asset classes, from the mundane to the mysterious.

Even neophyte medical investors can now buy and sell international equities, emerging market debt, mortgage securities, commodities, derivatives, indexes and currencies, offering infinitely more opportunities to make, or lose, money.

Amidst this ongoing proliferation, a unique asset class has emerged, one that is complex, non-traditional and not easily understood like stocks or bonds. It does, however, offer one invaluable advantage; its returns are virtually uncorrelated with any other asset class. When this asset class is introduced into a traditional investment portfolio, a wonderful thing occurs; the risk-return profile of the overall portfolio improves dramatically.

This asset class is known as a Market-Neutral strategy. The reason few medical professionals have heard of market neutral strategies is that most of them are offered by private investment partnerships otherwise known as hedge funds.

To the uninitiated, “hedge fund” means risky, volatile or speculative. With a market-neutral strategy however, just the opposite is true. Funds utilizing market-neutral strategies typically emphasize the disciplined use of investment and risk control processes. As a result, they have consistently generated returns that display both low volatility and a low correlation with traditional equity or fixed income markets. 

Definition of Market-Neutral

All market-neutral funds share a common objective: to achieve positive returns regardless of market direction. Of course, they are not without risk; these funds can and do lose money. But a key to their performance is that it is independent of the behavior of the markets at large, and this feature can add tremendous value to the rest of a portfolio.

A typical market-neutral strategy focuses on the spread relationship between related securities, which is what makes them virtually independent of underlying debt or equity markets. When two related securities are mispriced in relation to one another, the disparity will eventually disappear as the result of some external event. This event is called convergence and may take the form of a bond maturity, completion of a merger, option exercise, or simply a market recognizing the inefficiency and eliminating it through supply and demand.

Here’s how it might work

When two companies announce a merger, there is an intended future convergence, when the shares of both companies will converge and become one. At the time of the announcement, there is typically a trading spread between two shares. A shrewd trader, seeing the probability of the successful merger, will simultaneously buy the relatively cheaper share and sell short the relatively more expensive share, thus locking in the future gain.

Another example of convergence would be the relationship between a convertible bond and its underlying stock. At the time of convergence, such as bond maturity, the two securities will be at parity. However, the market forces of supply and demand make the bond underpriced relative to the underlying stock. This mispricing will disappear upon convergence, so simultaneously buying the convertible bond and selling short an equivalent amount of underlying stock, locks in the relative spread between the two.  

Yet another example would be two bonds of the same company – one junior and one senior. For various reasons, the senior bond may become cheaper relative to the junior bond and thus display a temporary inefficiency that would disappear once arbitrageurs bought the cheaper bond and sold the more expensive bond.

While these examples involve different types of securities, scenarios and market factors, they are all examples of a market-neutral strategy. Locking a spread between two related securities and waiting for the convergence to take place is a great way to make money without ever taking a view on the direction of the market.

How large are these spreads, you may ask? Typically, they are tiny. The markets are not quite fully efficient, but they are efficient enough to not allow large price discrepancies to occur.

In order to make a meaningful profit, a market-neutral fund manager needs sophisticated technology to help identify opportunities, the agility to rapidly seize those opportunities, and have adequate financing resources to conduct hundreds of transactions annually.  

Brief Description of Strategies

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The universe of market-neutral strategies is vast, spanning virtually every asset class, country and market sector. The spectrum varies in risk from highly volatile to ultra conservative. Some market-neutral strategies are more volatile than risky low-cap equity strategies, while others offer better stability than U.S Treasuries.

One unifying factor across this vast ocean of seemingly disparate strategies is that they all attempt to take advantage of a relative mispricing between various securities, and all offer a high degree of “market neutrality,” that is, a low correlation with underlying markets.

[A] Convertible Arbitrage

Convertible arbitrage is the oldest market-neutral strategy. Designed to capitalize on the relative mispricing between a convertible security (e.g. convertible bond or preferred stock) and the underlying equity, convertible arbitrage was employed as early as the 1950s.

Since then, convertible arbitrage has evolved into a sophisticated, model-intensive strategy, designed to capture the difference between the income earned by a convertible security (which is held long) and the dividend of the underlying stock (which is sold short). The resulting net positive income of the hedged position is independent of any market fluctuations. The trick is to assemble a portfolio wherein the long and short positions, responding to equity fluctuations, interest rate shifts, credit spreads and other market events offset each other.  

A convertible arbitrage strategy involves taking long positions in convertible securities and hedging those positions by selling short the underlying common stock. A manager will, in an effort to capitalize on relative pricing inefficiencies, purchase long positions in convertible securities, generally convertible bonds, convertible preferred stock or warrants, and hedge a portion of the equity risk by selling short the underlying common stock. Timing may be linked to a specific event relative to the underlying company, or a belief that a relative mispricing exists between the corresponding securities.

Convertible securities and warrants are priced as a function of the price of the underlying stock, expected future volatility of returns, risk free interest rates, call provisions, supply and demand for specific issues and, in the case of convertible bonds, the issue-specific corporate/Treasury yield spread.

Thus, there is ample room for relative misvaluations. Because a large part of this strategy’s gain is generated by cash flow, it is a relatively low-risk strategy. 

[B] Fixed-Income Arbitrage

Fixed-income arbitrage managers seek to exploit pricing inefficiencies across global markets.

Examples of these anomalies would be arbitrage between similar bonds of the same company, pricing inefficiencies of asset-backed securities and yield curve arbitrage (price differentials between government bonds of different maturities). Because the prices of fixed-income instruments are based on interest rates, expected cash flows, credit spreads, and related factors, fixed-income arbitrageurs use sophisticated quantitative models to identify pricing discrepancies.

Similarly to convertible arbitrageurs, fixed-income arbitrageurs rely on investors less sophisticated than themselves to misprice a complex security.

[C] Equity Market-Neutral Arbitrage

This strategy attempts to offset equity risk by holding long and short equity positions. Ideally, these positions are related to each other, as in holding a basket of S&P500 stocks and selling S&P500 futures against the basket. If the manager, presumably through stock-picking skill, is able to assemble a basket cheaper than the index, a market-neutral gain will be realized.

A related strategy is identifying a closed-end mutual fund trading at a significant discount to its net asset value. Purchasing shares of the fund gains access to a portfolio of securities valued significantly higher. In order to capture this mispricing, one needs only to sell short every holding in the fund’s portfolio and then force (by means of a proxy fight, perhaps) conversion of the fund from a closed-end to an open-end (creating convergence).

Sounds easy, right?

In considering equity market-neutral, you must be careful to differentiate between true market-neutral strategies (where long and short positions are related) and the recently popular long/short equity strategies.

In a long/short strategy, the manager is essentially a stock-picker, hopefully purchasing stocks expected to go up, and selling short stocks expected to depreciate. While the dollar value of long and short positions may be equivalent, there is often little relationship between the two, and the risk of both bets going the wrong way is always present.

[D] Merger Arbitrage (a.k.a. Risk Arbitrage)

Merger arbitrage, while a subset of a larger strategy called event-driven arbitrage, represents a sufficient portion of the market-neutral universe to warrant separate discussion.

Merger arbitrage earned a bad reputation in the 1980s when Ivan Boesky and others like him came to regard insider trading as a valid investment strategy. That notwithstanding, merger arbitrage is a respected stratagey, and when executed properly, can be highly profitable. It bets on the outcomes of mergers, takeovers and other corporate events involving two stocks which may become one.

A textbook example was the acquisition of SDL Inc (SDLI), by JDS Uniphase Corp (JDSU). On July 10, 2000 JDSU announced its intent to acquire SDLI by offering to exchange 3.8 shares of its own shares for one share of SDLI.

At that time, the JDSU shares traded at $101 and SDLI at $320.5. It was apparent that there was almost 20 percent profit to be realized if the deal went through (3.8 JDSU shares at $101 are worth $383 while SDLI was worth just $320.5). This apparent mispricing reflected the market’s expectation about the deal’s outcome. Since the deal was subject to the approval of the U.S. Justice Department and shareholders, there was some doubt about its successful completion. Risk arbitrageurs who did their homework and properly estimated the probability of success bought shares of SDLI and simultaneously sold short shares of JDSU on a 3.8 to 1 ratio, thus locking in the future profit.

Convergence took place about eight months later, in February 2001, when the deal was finally approved and the two stocks began trading at exact parity, eliminating the mispricing and allowing arbitrageurs to realize a profit. 

Merger Arbitrage, also known as risk arbitrage, involves investing in securities of companies that are the subject of some form of extraordinary corporate transaction, including acquisition or merger proposals, exchange offers, cash tender offers and leveraged buy-outs. These transactions will generally involve the exchange of securities for cash, other securities or a combination of cash and other securities.

Typically, a manager purchases the stock of a company being acquired or merging with another company, and sells short the stock of the acquiring company. A manager engaged in merger arbitrage transactions will derive profit (or loss) by realizing the price differential between the price of the securities purchased and the value ultimately realized when the deal is consummated. The success of this strategy usually is dependent upon the proposed merger, tender offer or exchange offer being consummated.  

When a tender or exchange offer or a proposal for a merger is publicly announced, the offer price or the value of the securities of the acquiring company to be received is typically greater than the current market price of the securities of the target company.

Normally, the stock of an acquisition target appreciates while the acquiring company’s stock decreases in value. If a manager determines that it is probable that the transaction will be consummated, it may purchase shares of the target company and in most instances, sell short the stock of the acquiring company. Managers may employ the use of equity options as a low-risk alternative to the outright purchase or sale of common stock. Many managers will hedge against market risk by purchasing S&P put options or put option spreads. 

[E] Event-Driven Arbitrage

Funds often use event-driven arbitrage to augment their primary market-neutral strategy. Generally, any convergence which is produced by a future corporate event would fall into this category.

Accordingly, Event-Driven investment strategies or “corporate life cycle investing” involves investments in opportunities created by significant transactional events, such as spin-offs, mergers and acquisitions, liquidations, reorganizations, bankruptcies, recapitalizations and share buybacks and other extraordinary corporate transactions.

Event-Driven strategies involve attempting to predict the outcome of a particular transaction as well as the optimal time at which to commit capital to it. The uncertainty about the outcome of these events creates investment opportunities for managers who can correctly anticipate their outcomes.

As such, Event-Driven trading embraces merger arbitrage, distressed securities and special situations investing. Event-Driven managers do not generally rely on market direction for results; however, major market declines, which would cause transactions to be repriced or break, may have a negative impact on the strategy. 

Event-driven strategies are research-intensive, requiring a manager to do extensive fundamental research to assess the probability of a certain corporate event, and in some cases, to take an active role in determining the event’s outcome. 

Risk and Reward Characteristics

To help understand market-neutral performance and risk, let’s take a look at the distribution of returns of individual strategies and compare it to that of traditional asset classes.

 Table 1:  Average Return / Volatility of Market Neutral Strategies And Selected Traditional Asset Classes 

 

Strategy Average Return Annualized Volatility
Convertible Arbitrage 11.95% 3.57%
Fixed Income Arbitrage 8.33% 4.90%
Equity Market-Neutral 11.62% 4.95%
Merger Arbitrage 13.29% 3.51%
Relative Value Arbitrage 15.69% 4.31%
   Traditional Asset Classes:    
S&P 500 12.62% 13.72%
MSCI World 8.57% 13.05%
High Grade U.S. Corp. Bonds 7.26% 3.73%
World Government Bonds 5.91% 5.96%

The most important observation about this chart is that the Market Neutral funds exhibits considerably lower risk than most traditional asset classes.

While market-neutral strategies vary greatly and involve all types of securities, the risk-adjusted returns are amazingly stable across all strategies. The annualized volatility – a standard measure of performance risk – varies between 3.5 and 5 percent, comparable to a conservative fixed-income strategy.     

Another interesting statistics is the correlation between Market Neutral strategies and traditional asset classes and traditional asset classes

Table 2: Correlation between Market Neutral Strategies and Traditional Asset Classes

 

Asset Class/Strategy S&P500 MSCI World GovBonds CorpBonds

The correlation of all market neutral strategies to traditional assets is quite low, or negative in some cases. This suggests that these strategies would indeed play a useful role in the ultimate goal of efficient portfolio diversification.

To test the “market neutrality” of these strategies, we asked, “How well, on average, did these strategies perform during bad, as well as good, market months?”

It turns out, in good times and bad, these strategies displayed consistent solid performance. From 12/31/91, in months when S&P 500 was down, the average down month was 3.03 percent. Market Neutral strategies performed as follows:

  

Strategy Average Monthly Return
Convertible Arbitrage + 0.65%
Fixed Income Arbitrage + 0.50%
Equity Market-Neutral + 1.19%
Merger Arbitrage + 0.88%
Relative Value Arbitrage + 0.81%

In months when S&P 500 was up, the average up month was +3.24 percent.  Market Neutral strategies performed as follows:

  

Strategy Average Monthly Return
Convertible Arbitrage +1.17%
Fixed Income Arbitrage +1.20%
Equity Market-Neutral +1.37%
Merger Arbitrage +0.60%
Relative Value Arbitrage +1.25%

Clearly, a compelling picture emerges. While these strategies, on average, underperform during good times, they show a positive average return during both good and bad markets.

Inclusion of Market-Neutral in a Long-term Investment Portfolio

A critical concern for any medical investor considering a foray into a new asset class is how it will alter the long-term risk/reward profile of the overall portfolio. To better understand this, we constructed several hypothetical portfolios consisting of traditional asset classes:

·  US Treasuries (Salomon Treasury Index 10yrs+)

·  High Grade Corporate Bonds  (Salomon Investment Grade Index)

·  Speculative Grade Corporate Bonds  (High Yield Index)

·  US Blue chip equities  (Dow Jones Industrial Average)

·  US mid-cap equities  (S&P 400 Midcap Index)

·  US small-cap equities (S&P 600 Smallcap Index)

Portfolios varied in the level of risk from 100 percent U.S Treasuries (least risky) to 100 percent small-cap equities (most risky), and are ranked from 1 to 10, 1 representing the least risky portfolio.Each portfolio was analyzed on a Risk/Return basis using monthly return data since December 1991. The results are shown in Chart 1.Predictably, the least risky portfolio produced the smallest return, while the riskiest produced the highest return. This is perfectly understandable – you would expect to be compensated for taking a higher level of risk.

Chart 1: Risk/Return characteristics of traditional portfolios vs. Market Neutral strategies 

Clearly, the risk-return picture offered by Market Neutral strategies is much more compelling (lower risk, higher return) than that offered by portfolios of traditional assets. What happens if we introduce these market-neutral strategies into traditional portfolios? Let’s take 20 percent of the traditional investments in our portfolio and reinvest them in market-neutral strategies.

The change is dramatic: the new portfolios (denoted 1a through 10a) offer significantly less risk for the same return. The riskiest portfolio, for instance (number 10) offered 20 percent less risk for a similar return of a new portfolio containing market-neutral strategies (number 10a).   
 
Chart 2:  Result of inclusion of 20% of Market Neutral strategies in traditional portfolios 

This is quite a difference.  Everything else being equal, anyone would choose the new, “improved” portfolios over the traditional ones.

How to invest

The mutual fund world does not offer a great choice of market neutral strategies. 

Currently, there are only a handful of good mutual funds that label themselves market-neutral (AXA Rosenberg Market Netural fund and Calamos Market Neutral fund are two examples).

Mutual fund offerings are slim due to excessive regulations imposed by the SEC with respect to short selling and leverage, and consequently these funds lack flexibility in constructing truly hedged portfolios. The dearth of market-neutral offerings among mutual funds is offset by a vast array of choices in the hedge fund universe. Approximately 400 market-neutral funds, managing $60 billion, represent roughly 25% of all hedge funds.

Therefore, further focus will relate to the hedge fund universe, rather than the limited number of market-neutral mutual funds.

Direct investing in a market-neutral hedge fund is restricted to qualifying individuals who must meet high net worth and/or income requirements, and institutional investors, such as corporations, qualifying pension plans, endowments, foundations, banks, insurance companies, etc.

This does not mean that retail investors cannot get access to hedge fund exposure. Various private banking institutions offer funds of funds with exposure to hedge funds. Maaket-neutral funds are nontraditional investments. They are part of a larger subset of strategies known as alternative investments, and there is nothing traditional in the way doctors invest in them.

Hedge funds are private partnerships, which gives them maximum flexibility in constructing and managing portfolios, but also requires medical investors to do a little extra work.

[A] Lockup Periods

One of the main differences between mutual funds and hedge funds is liquidity. Market-neutral strategies have less liquidity than traditional portfolios. Quarterly redemption policies with 45- or 60-days notice are common. Many funds allow redemptions only once a year and some also have lock-up periods. In addition, few of these funds pay dividends or make distributions. These investments should be regarded strictly as long-term strategies.

[B] Managerial Risks

Success of a market-neutral strategy depends much less on the market direction than on the manager’s skill in identifying arbitrage opportunities and capitalizing on them.

Thus, there is significantly more risk with the manager than with the market. It’s vital for investors to understand a manager’s style and to monitor any deviations from it due to growth, personnel changes, bad decisions, or other factors.

[C] Fees

If you are accustomed to mutual fund fees, brace yourself; market-neutral investing does not come cheap.

Typical management fees range from 1 to 2 percent per year, plus a performance fee averaging 20 percent of net profits. Most managers have a “high watermark” provision; they cannot collect the performance fees until investors recoup any previous losses. Look for this provision in the funds’ prospectus and avoid any fund that lacks it. Even with higher fees, market-neutral investing is superior to most traditional mutual fund investing on a risk-adjusted return basis.

[D] Transparency

Mutual funds report their positions to the public regularly. This is not the case with market-neutral hedge funds. Full transparency could jeopardize accumulation of a specific position. It also generates front running: buying or selling securities before the fund is able to do so. While you should not expect to see individual portfolio positions, many hedge fund managers do provide a certain level of transparency by indicating their geographical or sector exposures, level of leverage and extent of hedging.

It does take a bit of education to understand these numbers, but the effort is definitely worthwhile. 

[E] Taxation

The issue of hedge fund taxation is quite complex and is often dependent on the fund and the personal situation of the investor. Advice from a competent accountant, specialized financial advisor, tax attorney with relevant experience is worthwhile. The bottom line is that investing in market-neutral funds is not a tax-planning exercise and it will not minimize your taxes.

On the other hand, it should not generate any more or fewer taxes than if you invested in more traditional funds.

From the medical investor’s perspective, the principal advantages of market-neutral investing are attractive risk-adjusted returns and enhanced diversification.

Ten years of data indicate that market-neutral portfolios have produced risk-adjusted returns superior to traditional investments. In addition, the correlation between the returns of market-neutral funds and traditional asset classes has been historically negligible.

Adding exposure of market-neutral return strategies to the asset mix within a consistent, long-term investment program offers a medical investor the opportunity to improve overall returns, as well as achieving some protection against negative market movements.

Now, after all of the above, has your impression of hedge funds in general or MN funds in particular, changed?

APPENDIX:  

Asset class weighting in traditional portfolios:
Portfolio US Treasuries US High Grade Corp Bonds US Low Grade Corp Bonds Large Cap Stocks Mid Cap Stocks Small Cap Stocks
1 50% 50%        
2   50% 50%      
3 10% 30% 50% 40%    
4   50%   50%    
5   10% 10% 50% 30%  
6     10% 50% 20% 20%
7     10% 30% 20% 40%
8       20% 20% 60%
9         20% 80%
10           100%

 

Conclusion

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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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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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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)

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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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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.

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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

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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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DOCTORS: Marketing, Advertising & Sales

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DAILY UPDATE: Crude Oil Prices Reverse as Stock Markets Diverge

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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.

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

🟢 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%.

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 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™]

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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

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.

CITE: https://tinyurl.com/tj8smmes

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

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PHYSICIANS ONLY: Career Coaching and Development

MARCINKO ASSOCIATES, Inc.

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Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

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Deals, Stocks and the FOMC

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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  • Deals: Stocks popped at the open yesterday on the news that Canada has rescinded the digital services tax in order to lure the US back to the negotiating table. Meanwhile, Bloomberg reported that the EU will accept a 10% universal tariff in exchange for some key concessions.
  • Stocks: The S&P 500 and the NASDAQ both hit new record highs today, with the S&P 500 wrapping up its best quarter since Q4 20
  • The Fed: President Trump published a handwritten note asking Jerome Powell to cut interest rates, even as the White House considers new ways to replace the Fed Chair. Meanwhile, Goldman Sachs now sees the chances of the Fed cutting interest rates in September as “somewhat above 50%.”

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“BIG BEAUTIFUL BILL”: Not So for Healthcare?

By Health Capital Consultants; LLC

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On May 22, 2025, the U.S. House of Representatives moved President Trump’s budget proposal forward, sending to the Senate a budget reconciliation bill (with a one-vote margin) – the One Big Beautiful Bill Act of 2025 – that renews expiring tax cuts and enacts new ones at a cost of almost $4 trillion. These costs would largely be paid for by cuts to other programs, including to federal healthcare programs, which cuts will have significant ramifications for the healthcare industry.

This Health Capital Topics article reviews the current status of the budget bill and healthcare industry implications. (Read more…)

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VIX FEAR INDEX: Down

By AI

CBOE Volatility Index

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There’s a lot of confidence in markets these days, and nowhere is that more apparent than in the VIX, aka the CBOE Volatility Index, aka aka the Fear Index.

According to Brew Markets, the VIX literally measures the market’s expectation of volatility based on S&P 500 index options, but it’s become a shorthand way of quantifying investors’ fear or confidence. Any time the VIX rises above 30, it’s taken as a sign of some serious trepidation in the market—but anytime it falls below 20, the market is calm, cool, and collected.

The VIX skyrocketed to over 50 on Liberation Day as investors fretted over what tariffs meant for their portfolios, but it’s been gradually falling ever since. As the chart above shows, the VIX just fell below its key support level of 17—a mark it has failed to break below recently, and a move that underlines investors’ confidence that the good times will keep rolling.

VIX: https://medicalexecutivepost.com/2025/04/20/vix-stock-market-fear-gauge-update/

Whether or not that confidence is misplaced remains to be seen.

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ASSETS UNDER ADVISEMENT: Doctors Only

By Dr. David Edward Marcinko; MBA MEd CMP

A.U.A IS ALL WE DO!

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Assets under advisement refer to assets on which your firm provides advice or consultation but for which your firm does either does not have discretionary authority or does not arrange or effectuate the transaction. Such services would include financial planning or other consulting services where the assets are used for the informational purpose of gaining a full perspective of the client’s financial situation, but you are not actually placing the trade.

Assets under advisement could also be those which you monitor for a client on a non-discretionary basis, where you may make recommendations but where the client is the party responsible for arranging or effecting the purchase or sale.  A common example of this AUM scenario is when an advisor reviews a participant’s 401(k) allocations. If the adviser does not have the authority or ability to effect changes in the portfolio, these assets are likely considered assets under advisement rather than regulatory assets under management.

Assets under advisement are permitted to be disclosed on Form ADV Part 2A as a separate asset figure from the assets under management.  There is no requirement to disclose the assets under advisement figure, but some advisors opt to include the figure to give prospective clients a more complete picture of the firm’s responsibilities.  If you choose to report your assets under advisement, be sure to make a clear distinction between this figure and your regulatory assets under management.

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D. E. Marcinko & Associates Core Operating Values

9.   We act with honesty, integrity and are always straightforward.
8.   We strive to be innovative, creative, iconoclastic, and flexible.
7.   We admit and learn from mistakes and don’t repeat them.
6.   We work hard always as competitors are trying to catch up.
5.   We treat others with dignity and respect.
4.   We are the onus of consulting advice for the fiduciary well being of others.
3.   We fight complacency as former success is in the past.
2.   The best management styles are timeless, not timely.
1.   Our clients are colleagues and always come first.

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PARADOX: Social Media?

By Staff Reporters

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According to BetterHealth.com, billions of people worldwide use social media platforms today. While social media can be a helpful tool for connection in the digital age, it also has the power to contribute to loneliness and isolation. This is the essence of the social media paradox.

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What is the social media paradox?

The Merriam-Webster dictionary defines a paradox as “a statement that is seemingly contradictory or opposed to common sense and yet is perhaps true.” The social media paradox is a term coined to point out how, despite “social” being in the very name of it, social media has the potential to make people feel disconnected and lonely. 

As a Public Health Post article published by Boston University puts it, “The more time people spend actively engaging on social media—whether through posting, commenting, or messaging—the lonelier they may feel,” calling it “a double-edged sword.” This simple statement summarizes the core of the social media paradox.

So how could something “social” be so closely tied to isolation?

The effects of social media are complex. On the one hand, it has brought many positives to the lives of many people. It can help individuals stay connected, learn about themselves, and receive important information.

On the other hand, excessive social media use in particular also has the potential to separate and contribute to negative mental health outcomes.

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STOCK MARKETS: Rally Onward!

By A.I.

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Markets: That feeling when you have a $10 trillion rally. To wit:

The S&P 500 closed at a record high this week despite a brief dip as trade tensions with Canada ratcheted up. That puts the index about 20% up from its April low, when the broad tariff announcement sent it spiraling, and up ~5% for the year.

NVIDIA also hit an all-time high, and it keeps edging closer to becoming the first company to hit a $4 trillion valuation.

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FINANCIAL COACHING: For Physicians!

By Staff Reporters

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DEAR COLLEAGUES

If you are just starting out managing your finances and don’t know where to begin, a financial coach may be a good option for you. They are helpful for someone who wants to become proficient in the basics of finance, from learning how to budget or save money to building an emergency fund or creating a plan for paying off debt. If you have short-term money goals, like saving for a big purchase or just practicing better money habits, a financial coach can help you reach them by working with you to create a plan and holding you accountable. Even more for physicians and most all medical professionals.

Pros and Cons of Working with a Financial Coach
A financial coach can have a positive impact on your financial well–being and your life in a number of ways:

  • Financial coaches see the bigger picture of how you relate to money. They can help you develop better habits, resulting in positive personal growth.
  • By providing education and encouragement, they can reduce financial stress, confusion, and what it is about money that overwhelms you.
  • Through accountability and support, they can help you accomplish your goals and help you feel more confident in your finances.
  • Available 24/7/365.
  • Modest fees.

At you service.
Dr. David Edward Marcinko MBA MEd CMP

CONTACT: MarcinkoAdvisors@outlook.com

LINK: https://medicalexecutivepost.com/2025/01/23/personal-coaching-dr-marcinko-at-your-service/

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Stocks and Deals

By A.I.

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  • Deals: The US and China revealed the details of their trade deal framework, easing restrictions on rare earth metals and semiconductor chips. Commerce Secretary Howard Lutnick promised up to 10 more deals are on their way ahead of the July 9th tariff-pause deadline, but that probably won’t include Canada: President Trump ended all trade discussions with the country thanks to a dispute over the digital services tax.
  • Stocks: Indexes climbed at the open thanks to the deal with China, but they tumbled on news of a fallout with Canada. Still, the S&P 500 managed to post its 1,245th new all-time high, while the NASDAQ booked its own record close. The Dow trundled higher as well, though it’s still about 1,600 points below its previous record.

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DAILY UPDATE: Health Insurance Options as Bull Market Edges Upward

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A June 11th report from global professional services firm Alvarez & Marsal (A&M) predicts that more beneficiaries might soon ditch insurance coverage for options like short-term, limited duration plans or healthcare sharing ministries (HCSMs), which aren’t regulated like health insurance and aren’t required to comply with ACA protections like covering maternity care or pre-existing conditions.

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🟢 What’s up

  • Nvidia extended its winning streak to five days, rising another 1.73% as the AI trade continues to recover.
  • EchoStar climbed 13.16% after the parent company of Dish TV disclosed that President Trump did in fact prod the FCC to make a deal.
  • Cyngn soared another 20.07% following a big day of gains after the company that makes self-driving tech for industrial vehicles announced a partnership with Nvidia.
  • Strong earnings from Nike (more on that later) propelled sporting goods stocks higher today. ON Holdings rose 1.74%, while Dick’s Sporting Goods climbed 3.59%.
  • Domestic power producers popped on reports that Trump is planning to issue an executive order increasing energy production to meet AI demand. Vistra gained 2.44%, GE Vernova climbed 2.54%, and Vertiv added 2.71%.

What’s down

  • Coinbase Global ended its winning streak, tumbling 5.77% after GENIUS Act hype propelled the crypto stock skyward all week long. Traders took profits in Circle as well, pushing the stablecoin stock down 15.54%.
  • Chinese EV maker Li Auto fell 1.93% on its weaker-than-expected deliveries forecast for the second quarter.
  • Fellow Chinese EV maker Xiaomi stunned markets with reports that it received 240,000 orders for its new SUV within 18 hours of its debut, but shares still sank 4%.
  • Pony.ai lost 6.31% on a report that Uber is considering helping its founder Travis Kalanick fund his acquisition of the US subsidiary of the Chinese autonomous vehicle company.
  • Gold miners tumbled while the price of the precious metal fell as investors took a risk-on stance. Newmont lost 4.11%, Barrick Mining fell 3.44%, and Kinross Gold shed 6.18%.
  • Today’s trade deal reopens the door for Chinese rare earth imports, bad news for US producers like MP Materials (down 8.59%) and USA Rare Earth (down 12.14%).

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EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

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NEW AMA PRESIDENT: Robert Mukkamala MD

By Staff Reporters

NEWS UPDATE!

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On June 10th, Bobby Mukkamala was inaugurated as the 180th president of the American Medical Association (AMA).

An otolaryngologist from Flint, Michigan, Mukkamal chairs the organization’s substance use and pain care task force, won the AMA Foundation’s Excellence in Medicine Leadership Award last June, and served on the AMA board of trustees in 2017 and 2021.

COMMENTS APPRECIATED

EDUCATION: Books

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INVESTMENT ADVISORY: Portfolio Second Opinions for Physician Colleagues

INVESTMENT PORTFOLIO REVIEWS

By Dr David Edward Marcinko MBA MEd CMP

http://www.MarcinkoAssociates.com

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“FROM CHAOS-TO-CALM

If you’re looking at this tab, chances are you are fed up with your financial brokerage accounts, thinking of finances, investing, retirement or all of the above.

And so, we can help

An investment portfolio second opinion, also called a “ portfolio review,” is an analysis of your financial holdings and associated strategies, allocations, fees and performance to determine whether the most effective instruments and methodologies are being utilized to reach your goals.

No Worries! You may have come to the right place.

E-Mail Ann Miller RN MHA CPHQ for an Initial Appointment: MarcinkoAdvisors@outlook.com

The purpose of this initial appointment is for you to ask a lot of questions to make sure you are comfortable with potentially working with us. It also helps if you are prepared to provide a verbal summary of your current situation.

Here are some questions to consider asking us during your first meeting:

1) Can you tell us about your financial qualifications, experience, education and training; if any?

2) Can you provide some information about your current financial advisory team?

3) On what type of investments do you typically purchase and own?

5) How much do pay your financial management firm?

6) How long have you been working with your current financial management firm?

8) What other services does your financial team provide?

9) What is your own investment philosophy?

A Fiduciary Opinion At Your Service

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