BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on May 6, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Dr. Rochelle Walensky, the head of the Centers for Disease Control and Prevention, submitted her resignation yesterday, saying the waning of the COVID-19 pandemic was a good time to make a transition.
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The World Health Organization just reported that COVID-19 no longer qualifies as a global emergency, marking a symbolic end to the devastating coronavirus pandemic that triggered once-unthinkable lock-downs, upended economies and killed millions of people worldwide.
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Here’s where the major indexes ended:
The S&P 500® Index was up 75.03 points (1.9%) at 4136.25; the Dow Jones industrial average was up 546.64 (1.7%) at 33,674.38; the NASDAQ Composite was up 269.01 (2.3%) at 12,235.41.
The 10-year Treasury yield was up about 8 basis points at 3.431%.
CBOE’s Volatility Index was down 2.89 at 17.20.
Financial shares were a bright spot Friday, with the KBW Regional Banking Index up over 4% after sinking near a 2½-year low Thursday. Energy stocks were also strong as crude oil futures rallied over 4% and pushed back above $70 a barrel. Small-cap stocks also gained, with the Russell 2000 up more than 2%.
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* UNC Health might be able to expand its footprint faster, pending state approval. * A new chatbot called Pi is helping people with their emotional well-being. * The FDA approved the first RSV vaccine, which comes from GSK.
Posted on May 5, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Happy Cinco de Mayo. The holiday commemorates the defeat of French forces by the Mexican army at the Battle of Puebla in 1862, but its popularity jumped in the 1980s when beer companies began to leverage Cinco de Mayo in marketing campaigns.
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The antitrust watchdogs at the Federal Trade Commission (FTC) just tore into Facebook saying the agency has caught the social media giant violating kids’ data privacy for profit — for the third time. Now the FTC has had enough. In a new proposal to protect kids, the agency wants to ban the platform from ever monetizing youth data again. In a ferocious rebuke, the FTC said Facebook defied its direct order to protect kids’ online privacy and broke the promise the company made in a 2019 consent order when it was forced to pay a $5 billion penalty for violating a 2012 order.
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Here’s where the major indexes ended:
The S&P 500 Index was down 29.53 points (0.7%) at 4061.22; the Dow Jones industrial average was down 286.50 (0.9%) at 33,127.74; the NASDAQ Composite was down 58.93 (0.5%) at 11,966.40.
The 10-year Treasury yield was down about 4 basis points at 3.364%.
CBOE’s Volatility Index was up 1.74 at 20.08.
Financial stocks led the market’s declines, with the KBW Regional Banking index sinking nearly 3% to its lowest level since November 2020. Transportation stocks were also under pressure as banking sector troubles exacerbated recession concerns. Crude oil futures initially extended this week’s slump, dropping under $64 a barrel to a 17-month low before rebounding.
Posted on May 4, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
MAY THE FOURTH BE WITH YOU
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Many pharma companies reported earnings in the last week, and the common thread is crashing Covid-related sales.
For example, AstraZeneca’s Covid medication sales dropped $1.5b in Q1, Merck’s Covid antiviral sales fell 88% from the same quarter in 2022, and Roche’s diagnostics division sales fell 28% from Q1 2022, thanks to low Covid-test demand. Clearly, pharma companies have to figure out how to pivot their strategies in a post-Covid world.
The CDCwill not continue to track Covid-19 community spread as the country enters the endemic stage of the pandemic.
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The Food and Drug Administration approved Wednesday the first-ever vaccine to combat severe respiratory syncytial virus, or RSV. Arexvy, the new vaccine developed by GlaxoSmithKline, was approved for adults 60 and older and was 82% effective at preventing lower respiratory tract illness caused by RSV, according to trial data. It was also 94% effective in those who had at least one underlying medical condition.
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The Federal Reserve voted unanimously to raise interest rates by a quarter point yesterday, the tenth rate hike since the central bank started its battle against inflation last March. The move comes amid ongoing fragility in the banking sector triggered partly by higher interest rates, and following the collapse of three regional banks. Markets had anticipated the rate hike, and remained fairly muted after the Fed’s announcement.
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Finally, here’s where the major indexes ended up:
The S&P 500® Index was down 28.83 points at 4090.75; the Dow Jones industrial average was down 270.29 (0.8%) at 33,414.24; the NASDAQ Composite was down 55.18 (0.5%) at 12,025.33.
The 10-year Treasury yield was down about 7 basis points at 3.367%.
CBOE’s Volatility Index was up 0.52 at 18.30.
Energy companies were among the market’s weakest performers as crude oil continued a recent decline, with WTI crude futures falling more than 4% under $70 a barrel—a nearly six-week low.
Semiconductor and financial shares were also weak. The U.S. dollar index dropped sharply in the wake of the Fed announcement before rebounding.
Posted on May 3, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Here’s where the key indexes settled yesterday.
The S&P 500® Index was down 48.29 points (1.2%) at 4119.58; the Dow Jones industrial average was down 367.17 (1.1%) at 33,684.53; the NASDAQ Composite was down 132.09 (1.1%) at 12,080.51.
The 10-year Treasury yield was down about 15 basis points at 3.428%.
CBOE’s Volatility Index was up 1.67 at 17.77.
Regional banks led the declines, with the KBW Regional Banking index sinking more than 5% to its lowest level since late 2020.
Energy stocks were also weaker as crude oil futures extended a slide, dropping under $72 a barrel to their lowest level in more than five weeks. Small-caps also slumped, with the Russell 2000 index down 2%.
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More specifically, ahead of the Federal Reserve’s latest policy decision and fresh earnings results:
By 6:45pm ET (10:45pm GMT) Dow Jones Futures were flat while S&P 500 Futures and NASDAQ 100 Futures eased 0.1% apiece.
In extended deals, Advanced Micro Devices Inc (NASDAQ:AMD) fell 6.5% after reporting Q1 EPS of $0.60 versus $0.56 expected on revenues of $5.4 billion versus $5.3 billion expected. Looking ahead, the company forcasted Q2 2023 revenue in the range of $5-5.6 billion versus $5.49 billion expected.
Ford Motor (NYSE:F) slipped 1.6% after the company reported Q1 EPS of $0.63, beating expectations of $0.42,ewhile revenue was reported at $39.1 billion versus $37.4 billion expected.
Sprout Social (NASDAQ:SPT) dipped 17.4%, reporting Q1 EPS of $0.06, beating expected losses of $0.01 per share, while revenue came in at $75.2 million versus $75.07 million expected.
Posted on May 2, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Companies, mostly in tech and media, have laid off thousands of employees, so far this year. For example:
Amazon announced in early January that it’s eliminating 18,000 roles in total, including layoffs that were announced in November 2022. The company announced last month that it was laying off an additional 9,000 people.
Payments company PayPal is cutting 7% of its staff, which amounts to about 2,000 employees, President and CEO Dan Schulman said on Jan. 31st.
E-commerce company eBay announced in an SEC filing on Feb. 7 that it’s laying off 500 people, or 4% of its workforce.
And, Jenny Craig is saddled with $250 million in debt and has been looking for a buyer, Bloomberg Law reported in March. The weight loss industry is going through changes, as the obesity drug business has exploded in popularity. The medications, which mimic hormones found in the body to support weight loss, have recently grown in popularity thanks to reported use by celebrities and posts from everyday people on social media about successful weight loss.
Finally, General Motors terminated “several hundred” contract employees who worked at its Global Technical Center in Warren, Michigan, and other locations this weekend in its bid to shave $2 billion from its budget by the end of next year. The cuts come nearly a month after 5,000 salaried employees agreed to a voluntary separation package that GM said would help it achieve close to 50% of its cost-cutting target this year alone and prevent further involuntary cuts.
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Happy Tuesday! Today marks the first day of Mental Health Awareness Month. One in five US adults experiences mental illness each year, but fewer than half of them get care, according to the National Alliance on Mental Illness.
The MARKETS
The S&P 500® Index was down 1.61 points at 4167.87; the Dow Jones industrial average was down 46.46 (0.1%) at 34,051.70; the NASDAQ Composite was down 13.99 (0.1%) at 12,212.60.
The 10-year Treasury yield was up about 13 basis points at 3.585%.
Posted on May 1, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
Detailing Oversight Lapses
By Staff Reporters
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The Fed says it’s time for new bank rules
Just in time for a new looming bank failure, the Federal Reserve issued a 102-page report dissecting the corpse of Silicon Valley Bank. Meanwhile, FRB [First Republic Bank] FRB was just sold to JPMorgan Chase.
And in an accompanying letter, Michael Barr, the Fed’s vice chair for supervision, called for stricter rules to be applied to more financial institutions and for more tools to be given to regulators to bring firms with poor capital planning and risk management into line.
Posted on April 30, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Eli Lilly (NYSE: LLY) investors continued to be in a good mood about their stock on Friday. Following the estimates-beating first quarter reported by the big pharmaceutical company the previous morning, they traded the shares up by 1.4% on the final trading day of the week. That eclipsed the 0.8% gain of the S&P 500 index.
Researchers at MIT have created a new type of tabletop printer that spits out vaccine doses on demand in the form of thumbnail-size microneedle patches. Once scaled, this mobile technology could produce hundreds of doses per day, revolutionizing pandemic response. And in a boon for warmer or more remote parts of the world, the vaccine patches can be stored at room temperature for months before they’re slapped on—no refrigeration or professional administering required.
Posted on April 29, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Compensation pay for US workers picked up in the first three months of the year, showing that a major source of inflationary pressure persists and cementing the path for an interest rate hike at the Federal Reserve’s meeting next week. The Employment Cost Index, released Friday by the Bureau of Labor Statistics, showed that workers were paid 1.2% more in wages and benefits in the first quarter from the prior three-month period. That’s up from analysts’ expectations of 1.1%.
Markets: Stocks rose yesterday, finishing strong to give the Dow its best month since January. But First Republic Bank tanked again as rumors flew about its fate, again.
Economy: For all the Fed watchers, new data released makes it look like another rate hike could be in store next week. The data shows wages are still trending upward, and one of the Fed’s favorite inflation measures rose slightly last month.
Here’s where markets ended.
The S&P 500 Index was up 34.13 (0.8%) at 4169.48, a nearly three-month high; the Dow Jones industrial average was up 272.00 (0.8%) at 34,098.16; the NASDAQ Composite was up 84.35 (0.7%) at (12,226.58.
The 10-year Treasury yield was down about 9 basis points at 3.437%.
CBOE’s Volatility Index was down 1.27 at 15.76.
Energy companies were among the strongest sectors today with help from a rally in crude oil futures. Transportation and financial stocks were also strong. Utilities and consumer discretionary sectors were among the weakest sectors.
Posted on April 28, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Economy: The US economy entered a 12 mph zone last quarter, slowing to an annual growth rate of 1.1% (short of estimates). While the growth figures were discouraging and a consequence of the Fed’s interest rate hikes, economists found some bright spots! It seems that consumers won’t stop shopping, resulting in a 3.7% increase in consumer spending. Still, some are waiting on that recession?
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So – Here’s where the key indexes settled yesterday.
The S&P 500 Index was up 79.36 (2%) at 4135.35; the Dow Jones industrial average was up 524.29 (1.6%) at 33,826.16; the NASDAQ Composite was up 287.89 (2.4%) at 12,142.24.
The 10-year Treasury yield was up about 9 basis points at 3.524%.
CBOE’s Volatility Index was down 1.90 at 16.94.
Small-cap companies, which tend to struggle more when economic growth stalls, remained at the back of the pack, with the Russell 2000 up slightly over 1%.
The energy sector continued to rank among the weakest-performing sectors, as crude oil futures continued trading near lows for the month.
Treasury yields jumped to one-week highs after the first-quarter gross domestic product (GDP) report showed inflation remained elevated.
Posted on April 28, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
ECONOMIC OUTPUT
By Staff Reporters
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A government report on U.S. economic output in the first quarter will shed light on how consumers and businesses are faring under high inflation, rising interest rates and the onset of banking problems. Consumer spending, the primary driver of growth, and hiring were surprisingly strong at the start of the year, but more recently slowed as the Federal Reserve continued raising interest rates to cool the economy and curb rapid price increases. TO WIT:
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Meta’s “Year of Efficiency” is off to a strong start: After three straight quarters of falling revenue last year, the company saw an uptick in ad sales for a 3% revenue jump from Q1 2022. Profits were down, but the company still beat expectations, and Facebook gained users again after losses last year. But not all of Mark Zuckerberg’s dreams are coming true—the company’s Metaverse unit lost almost $4 billion last quarter.
Chipotle—which hit near all-time highs after saying customers kept coming back for burrito bowls despite price increases.
The UK’s competition regulator blockedMicrosoft’s bid to acquire the Call of Duty-maker saying it would hurt competition in the cloud gaming sector. The move came as a shock because the regulator had previously said Microsoft had assuaged its concerns about the console gaming market. The decision, which Microsoft plans to appeal, puts a strain on the deal while the companies wait for competition decisions from the EU and the US, where the FTC has already sued to scuttle it.
Finally, while egg prices have fallen dramatically, one sector of the economy remains stubbornly expensive: rents.
In the latest consumer price index report, the shelter category (aka rents) was the largest contributor by far to overall inflation. And despite moderating in recent months, rent growth remains 17% higher than 2021 levels.
Posted on April 26, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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DEFINITION: Startups areyoung companies or ventures that are founded to develop a unique or innovative product, service, or platform, and bring it to market. They are typically in the early stages of their development and face high uncertainty and failure rates. They are usually self-funded by the founders or seek external funding from investors or loans. They aim to grow large beyond the solo founder and disrupt existing industries or create new one.
SVB was relatively small—it had 40,000 customers compared to JPMorgan Chase’s 66 million—but it claimed to bank nearly half of all US tech and life sciences startups last year, including household names like Etsy, Roblox, and Roku. The cultural cachet of having a relationship with SVB as a venture-backed startup was like sporting a New Yorker tote at Whole Foods.
But the reason its loss will leave such a gaping hole in the startup community isn’t that it was cool to name-drop at a networking event. Because the bank was created in 1983 specifically to cater to venture-backed startups, it helped them in ways that most banks can’t—or won’t.
SVB chill loans: According to the MorningBrew, SVB would offer loans to startups more readily than large banks, basing the loans on a company’s ability to raise venture capital funds, not to turn a profit. SVB was also known for being flexible—even if startups breached their loan terms. “They were the easiest money for an unprofitable, early stage to mid-stage tech company,” Irving Investors founder Jeremy Abelson told The Information. And, even small startups received hand-holding services, such as guidance on how to set up their financial infrastructure. Its bankers personally called startups when they secured their first rounds of funding, according to The Information.
Startups now have to deal with big banks
Several founders who previously banked with SVB told Bloomberg that they’re moving their money to Chase and Bank of America, banks considered “too big to fail.”
Startups’ experience at big banks won’t be like their time at SVB. Not only is Jamie Dimon unlikely to call a startup to congratulate them on their Series A, but big banks are also expected to be more tight-fisted with their loans. The Office of the Comptroller of the Currency, a regulator that oversees large US banks, disapproves of loans to companies that are further out than one year from profitability, according to Crunchbase.
The loss of SVB is therefore expected to have a chilling effect on loans to venture-backed startups, aka “venture debt,” which SVB handed out more of than any other bank.
Posted on April 24, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Moody’s research released on Friday suggests that the industry is experiencing greater instability from several bank failures and high inflation, calling “into question whether some banks’ assumed high stability of deposits and their operational nature, should be reevaluated,”
The Wall Street Journal reported. Six U.S. banks were placed on Moody’s review list in March, per Reuters. All six banks put for review failed and were downgraded with the new study, including Comerica Inc., First Republic Bank, Intrust Financial Corporation, UMB Financial Corp, Western Alliance Bancorp and Zions Bancorporation.
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Apple’s latest product launch, in partnership with Goldman Sachs, is a savings account that will yield a meaty 4.15% in annual interest just for parking your money in it. The details:
You can open the savings account via the Wallet app on your iPhone, but you’ll need an Apple Card (Apple’s credit card) to be eligible.
No minimum deposit is required, the max balance is $250,000, and all of your funds are FDIC-insured.
Posted on April 22, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Earth Day is celebrated on April 22nd annually. The day was born out of a massive oil spill in Santa Barbara, California and carried forward today by the Earth Day Network. Earth day was created to help bring awareness and support for environmental protection around the world. Arbor Day is another popular observance to help the environment by encouraging individuals to plant trees and other plants in an effort to take care of our environment.
LYFT plans to cut 1,200 jobs as the latest cuts could impact 30% or more of its’ 4,000 employees.The company planned to announce the move after a board meeting next week but did so sooner. The cuts could help Lyft slash 50% of its costs as it doesn’t count drivers as employees.
The S&P 500® Index was up 3.73 points at 4133.52; the Dow Jones industrial average was up 22.34 at 33,808.96; the NASDAQ Composite was up 12.90 (0.1%) at 12,072.46.
The 10-year Treasury yield was up about 2 basis points at 3.566%.
CBOE Volatility Index was down 0.44 at 16.73.
Consumer Discretionary and Consumer Staples led gainers among S&P 500 sectors, while energy companies continued to slump in the wake of this week’s sell-off in crude oil prices. The PHLX Oil Service index sank 4% this week and ended at a three-week low. WTI crude futures rose slightly Friday but still dropped almost 6% for the week.
Earnings Round-Up
Major companies reporting quarterly results over the past day included:
Procter & Gamble (PG) reported Earnings Per Share (EPS) of $1.37 per share for the first quarter, about 5 cents above analysts’ forecasts, as well as stronger-than-expected revenue of $20.7 billion. The company also raised its outlook for 2023 organic sales growth to 6% from its earlier forecast of 4% to 5%. Its shares rose more than 3%.
Regions Financial (RF), the latest smaller U.S. bank to report, fell short of EPS forecasts, though revenue met expectations and deposits remained stable. The company’s shares fell about 3%.
CSX Corp. (CSX) reported first-quarter EPS of 48 cents, surpassing analysts’ expectations by about 5 cents, and revenue of $3.71 billion also topped forecasts. The railroad company’s shares rose more than 3%.
Schlumberger (SLB) reported net income of 63 cents per share, beating analysts’ forecasts of 61 cents, as well as higher-than-expected revenue. However, the oilfield service company’s shares more than 4% after suggesting the North American onshore market may plateau this year.
Freeport-McMoRan (FCX) reported a profit of 46 cents per share, which was better than analysts’ were expecting but still down by about half from a year earlier. The company’s mining volumes and supply chains were hampered by extreme weather and protests in Peru. The company’s shares fell more than 4%.
HCA Healthcare (HCA) reported EPS of $4.85, beating expectations by about 70 cents, and raised its earnings and revenue forecasts for the full year. Its shares jumped nearly 4%.
Posted on April 22, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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FTX is acryptocurrency exchange that was launched in 2018. It specializes in trading products such as derivatives, leveraged tokens, options, and volatility products. It supports most commonly traded cryptocurrencies and is powered by a top liquidity provider. FTX stands for Futures Exchange, a market where users can invest in commodities and foreign exchange.
Quote: “We sometimes find $50m of assets lying around that we lost track of; such is life.”
The sudden collapse of FTX might have been a lot less surprising if you’d been privy to Sam Bankman-Fried’s messages to his fellow executives.
According to a report by the bankrupt crypto exchange’s new management, SBF allegedly found the company’s lack of proper accounting amusing. The report says he described the company’s related hedge fund Alameda Research as “hilariously beyond any threshold of any auditor being able to even get partially through an audit” and joked about misplacing millions.
Posted on April 21, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
(Bloomberg) — A US debt default would threaten “a basic anchor” of the global financial system and “must not happen,” BlackRock Inc. Vice Chairman Philipp Hildebrand warned Thursday at the Bloomberg New Economy Gateway Europe forum.
“All we can do is to pray that everyone in the United States understands how important the sanctity of the sovereign signature of the leading currency, of the leading bond market, of the leading economy in the world is,” Hildebrand, a former president of the Swiss central bank, said during an on-stage interview. “This is not something you want to mess with.”
The 10-year Treasury yield hit a four-week high above 3.60% earlier this week, up from a seven-month low of 3.278% on April 4th.
The S&P 500 Index was down 24.73 (0.6%) at 4129.79; the Dow Jones industrial average was down 110.39 (0.3%) at 33,786.62; the NASDAQ Composite was down 97.67 (0.8%) at 12,059.56.
The 10-year Treasury yield was down about 7 basis points at 3.534%.
CBOEs Volatility Index was up 0.73 at 17.19.
Energy companies were among the weakest performers Thursday, as crude oil prices extended this week’s sell-off, with benchmark WTI futures down more than 2% to under $78 per barrel—a low for the month.
The real estate and technology sectors also lagged, while consumer staples and transportation sectors held up better.
Posted on April 20, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Meta Platforms, the billionaire’s social media empire, will reportedly cut thousands more jobs. And the bloodbath is not over, according to the latest reports. Meta plans to eliminate thousands more jobs. According to Bloomberg News, an internal memo has been sent to managers, asking them to prepare for tough new announcements. The job cuts, which total 4,000, are expected to affect Facebook, WhatsApp and Instagram. They would also affect Reality Labs, the division that houses the group’s Metaverse projects — Quest virtual-reality headsets. In 2021 and 2022, Reality Labs, which is supposed to build the company’s next big thing, recorded a cumulative loss of nearly $24 billion, including $13.7 billion just last year.
And, Walt Disney Company plans to cut thousands of jobs next week, in another lay-off round that includes about 15% of the staff in its entertainment division, according to people familiar with the plans. Disney Entertainment will bear a significant chunk of the job cuts – with approximately 15% of the division’s staffers set to exit next week, according to a report. Disney has more than 200,000 employees across its various businesses.
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And now, the Markets:
The S&P 500 Index fell 0.35 point to 4154.52; the Dow Jones industrial average was down 79.62 (0.2%) at 33,897.01; the NASDAQ Composite was up 3.81 at 12,157.23.
The 10-year Treasury yield was up about 2 basis points at 3.60%.
CBOE’s Volatility Index was down 0.37 at 16.46.
Transportation was one of the top gainers among S&P 500 sectors yesterday, thanks in part to strength in United Airlines (UAL) and other top carriers. Real estate and financials were also higher, while oilfield services stocks were among the weakest performers due to a sharp drop in crude oil prices. WTI futures fell below $80, their lowest level in nearly three weeks.
Oil prices rallied at the start of this month after members of OPEC+ announced a production cut.
Posted on April 18, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Tax deadline — April 18, 2023 — is today.
Did you know that the probability of being audited by the IRS is generally low, with less than 1% of tax returns receiving a second look? The average chance of being audited is 1 in 333, or 0.3%. But, certain factors can increase the likelihood of being audited, such as earning a lot of money or claiming complex deductions.
For example, the audit rate among filers with income of $10 million or more is 6.66%, while the audit rate for filers with incomes between $25,000 and $500,000 is roughly 0.5%. If selected for an audit, the taxpayer must demonstrate that the information on their tax return is correct
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The following is a round-up of yesterday’s market activity:
The S&P 500 Index was up 13.68 points (0.3%) at 4151.32; the Dow Jones industrial average was up 100.71 (0.3%) at 33,987.18; the NASDAQ Composite was up 34.26 (0.3%) at 12,157.72.
The 10-year Treasury yield was up about 8 basis points at 3.3.60%.
CBOE’s Volatility Index was down 0.13 at 16.94.
Among S&P 500 sectors, real estate stocks led advancers, while financials and industrials were also higher. Small-caps rose, with the Russell 2000 up about 1%. Communication services companies were among the weakest performers, and energy companies slumped as crude oil futures dropped nearly 2%.
The U.S. dollar index strengthened slightly, and equity market volatility remained subdued, with the VIX extending a decline to the lowest levels since late 2021.
National Healthcare Decisions Day (NHDD) exists to inspire, educate and empower the public and providers about the importance of advance care planning. NHDD is an initiative to encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be.
NHDD was founded in 2008 by Nathan Kottkamp, a Virginia-based health care lawyer, to provide clear, concise, and consistent information on healthcare decision-making to both the public and providers/facilities through the widespread availability and dissemination of simple, free, and uniform tools (not just forms) to guide the process.
NHDD is a series of independent events held across the country, supported by a national media and public education campaign. In all respects, NHDD is inclusive and brings a variety of players in the larger healthcare, legal, and religious community together to work on a common project, to the benefit of patients, families, and providers. A key goal of NHDD is to demystify healthcare decision-making and make the topic of advance care planning inescapable. Among other things, NHDD helps people understand that advance healthcare decision-making includes much more than living wills; it is a process that should focus first on conversation and choosing an agent.
As of June 2016, The Conversation Project has been responsible for the management, finances, and structure of NHDD. NHDD’s founder, Nathan Kottkamp, continues to be involved in NHDD and provides leadership by ensuring the maintenance of NHDD’s high quality resources and support for the community.
DEFINITION: What is advance care planning for financial advisors and lawyers?
Advance care planning involves discussing and preparing for future decisions about your medical care if you become seriously ill or unable to communicate your wishes with your estate planning attorney or financial advisor. Having meaningful conversations with your loved ones is the most important part of advance care planning. Many people also choose to put their preferences in writing by completing legal documents called advance directives.
What are advance directives?
Advance directives are legal documents that provide instructions for medical care and only go into effect if you cannot communicate your own wishes.
The two most common advance directives for health care are the living will and the durable power of attorney for health care.
Living will: A living will is a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment. In a living will, you can say which common medical treatments or care you would want, which ones you would want to avoid, and under which conditions each of your choices applies. Learn more about preparing a living will.
Durable power of attorneyfor health care: A durable power of attorney for health care is a legal document that names your health care proxy, a person who can make health care decisions for you if you are unable to communicate these yourself. Your proxy, also known as a representative, surrogate, or agent, should be familiar with your values and wishes. A proxy can be chosen in addition to or instead of a living will. Having a health care proxy helps you plan for situations that cannot be foreseen, such as a serious car accident or stroke. Learn more about choosing a health care proxy.
Think of your advance directives as living documents that you review at least once each year and update if a major life event occurs such as retirement, moving out of state, or a significant change in your health.
Advance care planning is not just for people who are very old or ill. At any age, a medical crisis could leave you unable to communicate your own health care decisions. Planning now for your future health care can help ensure you get the medical care you want and that someone you trust will be there to make decisions for you.
Advance care planning for people with dementia. Many people do not realize that Alzheimer’s disease and related dementias are terminal conditions and ultimately result in death. People in the later stages of dementia often lose their ability to do the simplest tasks. If you have dementia, advance care planning can give you a sense of control over an uncertain future and enable you to participate directly in decision-making about your future care. If you are a loved one of someone with dementia, encourage these discussions as early as possible. In the later stages of dementia, you may wish to discuss decisions with other family members, your loved one’s health care provider, or a trusted friend to feel more supported when deciding the types of care and treatments the person would want.
What happens if you do not have an advance directive?
If you do not have an advance directive and you are unable to make decisions on your own, the state laws where you live will determine who may make medical decisions on your behalf. This is typically your spouse, your parents if they are available, or your children if they are adults. If you are unmarried and have not named your partner as your proxy, it’s possible they could be excluded from decision-making. If you have no family members, some states allow a close friend who is familiar with your values to help. Or they may assign a physician to represent your best interests. To find out the laws in your state, contact your state legal aid office or state bar association.
Will an advance directive guarantee your wishes are followed?
An advance directive is legally recognized but not legally binding. This means that your health care provider and proxy will do their best to respect your advance directives, but there may be circumstances in which they cannot follow your wishes exactly. For example, you may be in a complex medical situation where it is unclear what you would want. This is another key reason why having conversations about your preferences is so important. Talking with your loved ones ahead of time may help them better navigate unanticipated issues.
There is the possibility that a health care provider refuses to follow your advance directives. This might happen if the decision goes against:
The health care provider’s conscience
The health care institution’s policy
Accepted health care standards
In these situations, the health care provider must inform your health care proxy immediately and consider transferring your care to another provider.
Other advance care planning forms and orders from doctors
You might want to prepare documents to express your wishes about a single medical issue or something else not already covered in your advance directives, such as an emergency. For these types of situations, you can talk with a doctor about establishing the following orders:
Do not resuscitate (DNR) order: A DNR becomes part of your medical chart to inform medical staff in a hospital or nursing facility that you do not want CPR or other life-support measures to be attempted if your heartbeat and breathing stop. Sometimes this document is referred to as a do not attempt resuscitation (DNR) order or an allow natural death (AND) order. Even though a living will might state that CPR is not wanted, it is helpful to have a DNR order as part of your medical file if you go to a hospital. Posting a DNR next to your hospital bed might avoid confusion in an emergency. Without a DNR order, medical staff will attempt every effort to restore your breathing and the normal rhythm of your heart.
Do not intubate (DNI) order: A similar document, a DNI informs medical staff in a hospital or nursing facility that you do not want to be on a ventilator.
Do not hospitalize (DNH) order: A DNH indicates to long-term care providers, such as nursing home staff, that you prefer not to be sent to a hospital for treatment at the end of life.
Out-of-hospital DNR order: An out-of-hospital DNR alerts emergency medical personnel to your wishes regarding measures to restore your heartbeat or breathing if you are not in a hospital.
Physician orders for life-sustaining treatment (POLST) and medical orders for life-sustaining treatment (MOLST) forms:These forms provide guidance about your medical care that health care professionals can act on immediately in an emergency. They serve as a medical order in addition to your advance directive. Typically, you create a POLST or MOLST when you are near the end of life or critically ill and understand the specific decisions that might need to be made on your behalf. These forms may also be called portable medical orders or physician orders for scope of treatment (POST). Check with your state department of health to find out if these forms are available where you live.
At enrollment, Medicare in the future could offer three advancedirectives with goals of care: DirectiveA: CONSENT to treat — inpatient medical treatment DirectiveB: CONSENT to comfort — home bound holistic care DirectiveC: CHOOSE against medical advice — outpatient palliative resources.
The Fed rate hikes that spelled doom for smaller fries like Silicon Valley Bank and Signature Bank were a boon to the big potatoes since they could charge more for loans. With the money they made from lending shooting up, JPMorgan, Citigroup, and Wells Fargo all zoomed past expectations for Q1.
JPMorgan, the biggest of the big, posted record revenues and saw its profits spike to $12.6 billion, 52% more than the same quarter last year.
Citigroup, the third largest US bank, scored $4.6 billion in profit, 7% higher than in Q1 2022.
Wells Fargo, the fourth largest, kept the hot streak going with a 32% increase in profits from the first quarter of ’22 to just under $5 billion.
The banking behemoths have made it through the chaos caused by the biggest bank failures since 2008 not just unscathed but stronger—though there’s some debate over whether they’ll be able to hang on to the many new deposits that came their way as customers fled from regional lenders.
But smaller banks are still struggling. And there were signs the three megabanks weren’t ready to declare total victory: They cautioned that credit is likely about to get more expensive and put aside a combined $2 billion in case a recession hits.
Posted on April 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Yesterday, the S&P notched its highest close since February with a boost from Big Tech names such as Amazon, Meta, Alphabet, and Netflix, which each gained at least 2.7% (FAANG).
This morning however, all eyes are on bank earnings as JPMorgan, Citigroup, and Wells Fargo report before the opening bell.
Posted on April 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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According to Wikipedia, the Web3 (also known as Web 3.0 and sometimes stylized as web3) is an idea for a new iteration of the World Wide Web based on blockchain technology, which incorporates concepts such as decentralization and token-based economics. Some technologists and journalists have contrasted it with Web 2.0, wherein they say data and content are centralized in a small group of companies sometimes referred to as “Big Tech“. The term “Web3” was coined in 2014 by Ethereum co-founder Gavin Wood, and the idea gained interest in 2021 from cryptocurrency enthusiasts, large technology companies, and venture capital firms.
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Now, some experts argue that web3 will provide increased data security, scalability, and privacy for users and combat the influence of large technology companies.
Others have raised concerns about a decentralized web, citing the potential for low moderation and the proliferation of harmful content,the centralization of wealth to a small group of investors and individuals, or a loss of privacy due to more expansive data collection. Others, such as Elon Musk and Jack Dorsey, have argued that web3 only currently serves as a buzzword.
Posted on April 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A rally on Wall Street yesterday is lifting stocks to their highest level in almost two months following the latest sign that inflation continues to cool. Yesterday’s report showed that prices paid to producers last month were 2.7% higher than a year earlier, the lowest inflation level there in more than two years. The hope on Wall Street is that easier inflation on the wholesale level will not only support profits for companies but also flow through to cooler inflation for consumers. A day earlier, a separate report said inflation for consumers slowed to 5%.
Inflation and how high the Federal Reserve will hike interest rates to tame it have been at the center of Wall Street’s struggles for more than a year. The Fed has hiked rates at such a feverish pace over the last year that it’s already slowed parts of the economy and caused strains to appear in the banking system.
And so, stocks climbed on the cooler-than-expected PPI, and perhaps some optimism around the Q1 earnings season, with several big banks reporting Friday. However, expectations around Fed policy didn’t budge much.
Bond yields were little changed and markets still see a 70% probability of the Fed enacting a quarter-point rate increase in May, according to the CME FedWatch tool.
The following is a round-up of yesterday’s market activity:
The S&P 500 Index was up 54.27 points (1.3%) at 4146.22; the Dow Jones industrial average was up 383.19 (1.1%) at 34,029.69; the NASDAQ Composite was up 236.93 (2.0%) at 12,166.27.
The 10-year Treasury yield was up about 3 basis points at 3.447%.
Posted on April 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A 2020 analysis of Doximity’s physician compensation data found that men physicians make an estimated $2 million more than women over the course of their careers.
Men physicians outearned women physicians by at least 10% across all specialties, except pediatric cardiology (9.2%) and nuclear medicine (3%).
Specialties with the largest gender pay gaps were: oral and maxillofacial surgery ($568,789 vs. $395,687), pediatric pulmonology ($282,272 vs. $227,958), allergy and immunology ($329,634 vs. $268,938), urology ($515,850 vs. $424,733), and ophthalmology ($468,515 vs. $387,295).
Specialities with the smallest gender pay gaps were: nuclear medicine ($394,231 vs. $382,431), pediatric cardiology ($334,384 vs. $303,622), pediatric gastroenterology ($293,771 vs. $264,135) hematology ($358,736 vs. $320,938), and medicine/pediatrics ($283,034 vs. $253,019).
Posted on April 13, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The consumer-price index, a closely watched inflation gauge that measures what consumers pay for goods and services, rose 5% last month from a year earlier, down from February’s 6% increase and the smallest gain since May 2021, the Labor Department said yesterday. Earlier, the consumer price index for March came in below expectations, rising 0.1% monthly compared to forecasts for a 0.2% increase. Many other indicators have inflation continuing to fall in the coming months as tightening credit conditions and weaker economic demand take a bite out of economic growth.
The following is a round-up of today’s market activity:
The S&P 500 Index was down 16.99 (0.4%) at 4091.95; the Dow Jones industrial average was down 38.29 (0.1%) at 33,646.50; the NASDAQ Composite was down 102.54 (0.9%) at 11,929.34.
The 10-year Treasury yield was down about 3 basis points at 3.404%.
CBOE’s Volatility Index was down 0.01 at 19.09.
Technology stocks led Wednesday’s declines, with the PHLX semiconductor index sinking 1.8%. Consumer discretionary and transportation were also among the weakest sectors, while oilfield services led gainers as crude oil prices extended a recent rally.
WTI crude futures jumped over 2% above $83 a barrel and ended near a five-month high. Gold futures rose a second straight day and remain above $2,000 an ounce.
Posted on April 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
What is Your Opinion?
By Staff Reporters
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Markets: Stocks ran on a treadmill yesterday as investors waited for the high-stakes inflation report to drop this morning. Major cryptocurrencies have emerged as the biggest winners of 2023 so far, and Bitcoin topped $30,000 for the first time in 10 months.
Dueling economic visions: Depending on who you ask, the economy is doing just fine…or it’s about to slow down dramatically. Treasury Secretary Janet Yellen said yesterday that “the US economy is obviously performing exceptionally well.” But that’s not obvious at all to the IMF, which predicted weak global growth this year and gave its gloomiest five-year economic forecast since 1990.
Posted on April 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A closely-watched government measure of inflation is expected to show that price increases cooled further last month. March’s Consumer Price Index (CPI), slated for release today,is expected to come in at5.2%, a slowdown from February’s 6% annual gain, according to estimates from Bloomberg. The number would mark the slowest annual increase in consumer prices since May 2021 but would still be significantly above the Federal Reserve’s 2% target. The Fed has been raising interest rates to try to bring down inflation, but the central bank risks sending the economy into a recession by hiking rates too high too fast.
The following is a round-up of today’s market activity:
The S&P 500® Index was down 0.17 point at 4108.94; the Dow Jones industrial average was up 98.27 (0.3%) at 33,684.79; the NASDAQ Composite was down 52.48 (0.4%) at 12,031.88.
The 10-year Treasury yield was up about 1 basis point at 3.428%.
CBOE’s Volatility Index was up 0.12 at 19.09.
Energy companies led the gainers, with the PHLX Oil Service Index jumping nearly 2% behind strength in crude oil futures, which rallied to their highest levels since late January. The transportation and financial sectors were also strong.
The U.S. dollar weakened slightly, while gold futures climbed nearly 1% to end a three-day tumble.
Posted on April 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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GROWING SCRUTINY OF TELE-MEDICINE
On July 20, 2022, the Office of Inspector General (OIG) of the U.S. Department of Health & Human Services (HHS) released a Special Fraud Alert on telemedicine. On the same day, the U.S. Department of Justice (DOJ) announced a “nationwide coordinated law enforcement action” against 36 defendants, and the Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity announced administrative actions against 52 providers, related to alleged telemedicine arrangements. These coordinated actions indicate a growing scrutiny of telemedicine arrangements by federal government regulators. (Read more...)
Posted on April 11, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Starwood Capital CEO Barry Sternlicht, who has a net worth of $4.6 billion, says inflation is going to drop—and it’s going to drop hard. In an interview with CNBC’s Squawk Box, Sternlicht was asked what he’d say in response to JPMorgan Chase CEO Jamie Dimon’s annual letter to shareholders, in which Dimon writes that current economic conditions “create more risk and potentially higher inflation,” and higher rate hikes.
However, after saying he’s a big fan of Dimon and that he runs “probably one of the best banks in the world,” Sternlicht clarified to CNBC that “we don’t agree on everything.”
The following is a round-up of yesterday’s market activity:
The S&P 500® Index was up 4.09 (0.1%) at 4109.11; the Dow Jones industrial average was up 101.23 (0.3%) at 33,586.52; the NASDAQ Composite was down 3.6 at 12,084.36.
The 10-year Treasury yield was up about 4 basis points at 3.419%.
CBOEs Volatility Index was up 0.54 at 18.94.
Energy and transportation were the strongest-performing S&P 500 sectors, while communications services was the biggest laggard. WTI crude oil futures fell slightly but remained near two-month highs posted last week.
Gold futures fell sharply for the second session in a row. The U.S. dollar index jumped to its strongest level in nearly two weeks.
Posted on April 10, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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We trust everyone had a good weekend as Easter, Ramadan, and Passover were all overlapping. This typically happens only three times a century.
So, as investors head back to work after the three-day weekend, today’s stock moves will focus on Friday’s solid jobs numbers. Checking in on the S&P’s 2023 performance suggests that almost 90% of the index’s gains this year is accounted for by just 20 stocks, Nvidia, Apple, and Meta among them, the Financial Times notes.
And, corporate earnings pick back up this week and will influence the direction of the stock market for the next several months. Big banks, including JPMorgan and Citigroup, will drop their Q1 results on Friday, so we’ll learn how the collapse of SVB impacted them.
Finally, even as the US demands ByteDance to sell TikTok, fresh numbers show why it’s determined to hold on. The Chinese tech giant posted record underlying profit last year (EBIDTA) and is now more profitable than fellow Chinese tech giants Alibaba and Tencent, per the Financial Times. ByteDance grew sales 30% in 2022 to $85 billion, and its profits surged 79% to $25 billion. Worth $300 billion last year, ByteDance is the world’s most valuable private company.
Posted on April 9, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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According to the Financial Times, just 20 stocks account for almost 90 per cent of the US benchmark index’s $2.36tn gains so far this year, as instability in the banking sector has driven down interest rate expectations and boosted the attraction of Big Tech.
Among the big gainers, shares in chip-maker Nvidia have climbed by 83 per cent so far this year, while Facebook owner Meta is up 76 per cent and Salesforce has climbed 42 per cent, underlining the heavy concentration in the world’s most influential stock market. The market value of those and the other 17 best performing stocks in the S&P 500 have surged by $2.05tn in 2023. Apple’s valuation alone has shot up by almost $600bn, or 30 per cent, in the past three months.
And, according to Yahoo Finance, the market capitalization of the other stocks in the index — which is up almost 7 per cent so far in 2023 — has risen just $320bn over the same period.
Finally, according to private equity firm Apollo Global Management and ignoring gains for mega-cap growth stocks, the S&P 500 rose just 1.4 per cent in the first three months of 2023, said UBS.
Posted on April 8, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
U.S. Department of Labor
By Staff Reporters
It is Easter Weekend Saturday which was a stock market holiday weekend but not a federal holiday. That results in a highly unusual scenario when the government released the pivotal jobs report yesterday. Good Friday, the stock market didn’t open to react to it. Investors will have to spend three days before placing their wagers on Monday.
Nevertheless, the Bureau of Labor Statistics’ (BLS) report yesterday [Friday] was on par with what economists had expected from the jobs market as the Fed hiked interest rates. March saw about 75,000 fewer jobs added to the economy compared with February, which was already a drop compared with the 504,000 jobs that were added in January. The unemployment rate dropped 0.1% to 3.5%. Fewer jobs were added to leisure and hospitality and healthcare than in previous months, though the industries are still trending up in job availability. Government and professional and business services continued to grow at similar paces as previous months. Ahead of the government’s job survey other reports gave hints that the labor market, while still growing, is cooling from highs seen over the last two years. BLS’ Job Openings and Labor Turnover Survey last week showed that employers are starting to slow the pace of hiring. There were less than 10 million active job openings by the end of February for the first time in nearly two years.
Friday’s jobs report provided data that will heavily influence the Fed’s decision to either halt or continue interest rate hikes at its next board meeting in early May.
Posted on April 7, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson, CFA
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This is part one of the post winter seasonal letter I wrote to IMA clients, sharing my thoughts about the economy and the market. I tried something I’ve never done before. Instead of conveying my message through storytelling, I tried to compress my thoughts into short sentences. I summarized some 50,000 words into about 1,000 (a compression ratio of 50 to 1!).
Posted on April 6, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Understanding FDIC insurance limits
The FDIC wants to make sure it can cover everyone with a bank account, so to make that happen, it caps how much money it insures. The FDIC says its standard is to cover up to “$250,000 per depositor, per insured bank, for each account ownership category.
Here’s an example: Let’s say you have $100,000 in your checking account and $150,000 in your savings, all at the same bank. The FDIC classifies those under the same category: single accounts.So you would have hit your FDIC deposit limit. Every additional cent deposited into either account would be uninsured. But if you have money in other banks or other deposit categories, you may have additional coverage.
Could the insured deposit cap get a lift?
At least four US lawmakers—two from each side of the aisle—said they would support raising the cap on FDIC-insured deposits in order to reassure frazzled bank customers that their deposits are safe. The current cap is $250,000 (up from $100k pre-financial crisis), but Democratic Sen. Elizabeth Warren said bumping it up “is a good move.” Opponents of raising the cap say it would only increase risk-taking and bad behavior by banks. Some even argue we should lower it.
Posted on April 5, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Happy Passover to all those celebrating tonight
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Johnson & Johnson proposes monster $8.9 billion talc settlement. The healthcare giant offered $8.9 billion to settle lawsuits from tens of thousands of people who claim that its talc-based powders and other products gave them cancer. It’s a huge increase from the $2 billion J&J originally offered and would be one of the largest product liability settlements in history, according to the WSJ. To clinch the settlement, J&J needs support from more than 75% of the voting claimants—and it thinks it has it.
And here’s how the major indexes performed yesterday, Tuesday:
The S&P 500 Index fell 23.91 points (0.6%) to 4,100.60; the Dow Jones industrial average fell 198.77 (0.6%) to 33,402.38; the NASDAQ Composite fell 63.13 (0.5%) to 12,126.33.
The 10-year Treasury yield fell about 9 basis points to 3.346%.
Small-cap stocks were among the weakest performers Tuesday, with the Russell 2000 index sinking more than 2%. Industrial, energy, and financial stocks led decliners among S&P 500 sectors. Gold futures surged to a 13-month high, while the U.S. dollar index slipped.
Shares of Walmart fell as the largest U.S. retailer began its investor meeting Tuesday. Comments from Walmart executives could offer indications on the overall financial health and spending patterns of U.S. consumers. The company said in February that high prices and weak demand for discretionary items could be headwinds.
Posted on April 4, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Major U.S. stock indexes ended mixed, after the announcement of a surprise OPEC+ production cut sent crude oil prices to two-month highs and fueled inflation concerns that could keep the Federal Reserve in policy-tightening mode. This weekend, several OPEC+ members, including Saudi Arabia, announced production cuts totaling nearly 1.2 million barrels a day that are slated to start in May. In response, WTI crude futures soared above $80 a barrel. Word of the planned cuts also boosted expectations that the Fed could raise its benchmark interest rate again in May as the central bank extends efforts to tamp down inflation. The OPEC+ cuts “suggest more headline inflation pressure in the near-term,” says Jeffrey Kleintop, chief global investment strategist at Charles Schwab & Co. The potential for further waves of inflation will “keep central banks from declaring victory over excessive price gains,” he adds. “That’s another headwind for tech stocks and other ‘long duration’ equities that get more of their cash flow in the future than in the near term.”
The following is a round-up of today’s market activity:
The S&P 500® Index was up 15.2 (0.4%) at 4124.51, the highest close since Feb. 15; the Dow Jones industrial average was up 327 (1.0%) at 33601.15; the NASDAQ Composite was down 32.45 (0.3%) at 12189.45.
The 10-year Treasury yield was down about 7 basis points at 3.417%.
CBOE’s Volatility Index was down 0.14 at 18.56.
Oil producers and other energy companies led gainers Monday. Health care stocks also outperformed. Consumer discretionary and real estate were among the laggards.
Among individual stocks, Tesla (TSLA) shares tumbled over 6% following reports the electric car-maker delivered just 423,000 vehicles in the first quarter. Analysts had expected 430,000, according to research firm FactSet.
Looking ahead, medical companies, especially vaccine makers, may be worth watching this week with the World Vaccine Congress taking place in Washington, D.C. Some well-known vaccine makers include Moderna (MRNA), Johnson & Johnson (JNJ), and GlaxoSmithKline (GSK). Late last month, Walgreens Boots Alliance (WBA) reported a steep year-over-year decline in demand for COVID-19 vaccinations.
The U.S. dollar index fell slightly, while gold futures climbed above $2,000 per ounce to post their highest close in over two years.
Posted on April 3, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Nouriel Roubini says the economy is headed for a “doom loop”. That’s due to three stressors in the economy, which will leave the Fed unable to fight a recession. Roubini, who called the 2008 downturn, has long warned of imminent financial chaos. And, he has more dire words of warning for the economy.
“Dr. Doom” warned in a column this week that the US face a major financial crisis and the economy is entering what he calls a “doom loop”.
In an op-ed for Project Syndicate on Thursday, Roubini forecasted a coming cycle of economic pain, as the US struggling under both high inflation and high debt burdens. Those issues perpetuate each other, he said, warning of a recession and impending financial crisis that would only get worse the longer it dragged on.
During an appearance on “Fox & Friends Weekend,” Breitbart economics editor John Carney warned that the dollar’s feeble valuation could be a “serious threat” to the U.S.’s crucial influence on the world stage.
“”[It’s] not only a serious threat, I think it is inevitable. We went through three stages, as you said, after World War II. The U.S. was the biggest economy in the world. In the 1970s, global banking became basically dollar central. With the fall of the Soviet Union, the entire world, more or less, came under the domination of the U.S dollar…”
Posted on April 2, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
All about the Medical Executive-PostBusiness Model
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One of the questions we receive most often from readers of the Medical Executive-Post is how can we “afford” to give away so much content for free. Or stated another way, “how do we get paid for all of this?”
The simple answer is that we know many (or even most) of you will simply take the ideas that we share and implement them yourself. Do-It-YourSelfers can always simply purchase our texts, books and peer reviewed handbooks redacted in more than a thousand, medical, law, business and graduate schools, as well as the Library of Congress,Institute of Health and Library of Congress.
On the other hand, some of you will realize you need some additional help.
For example:
Maybe as a financial advisor you’re “stuck” in your financial planning business and recognize that some outside assistance is necessary to help you get to the next level of niche specificity thru our Certified Medical Planner™ chartered certification program designation. Helping physicians of all specialty types in a fiduciary focused manner is the proverbial Win-Win for all concerned.
OR, perhaps you are seeking a glossary of terms and definitions in heath economics, finance, accounting, insurance, managed care, health information technology and security; found in our Health Dictionary Series Wiki Project? Free and print versions are available.
OR, as a doctor maybe your medical practice is growing so much you just hit a wall where you don’t have time to do it all for your patients. After all, with only “so much” time available every day and week, it’s vital to delegate or outsource anything that isn’t really core to your practice and management skill set.
OR, maybe you are even starting, buying or selling your medical practice and need our financial and valuation services. Part (1) – Part (2) – Part (3) Financial, estate, investing and retirement planning services are also available.
OR, you may just need a second informed opinion about a topic not listed; there are a myriad of issues to consider in the competitive ecosystem today.
So, in the meantime, I hope that the ME-P content continues to be helpful food for thought, and perhaps we’ll have an opportunity to cross paths soon at a future conferences or podcasts. Feel free to invite us to speak at your own seminar/podcast online V-log, as well.
Posted on April 2, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A disastrous month of March is what Charles Schwab has just experienced. An avalanche of bad news fell on the firm. The stock fell 33% between Feb. 28 and Mar. 31. At the end of February, Charles Schwab’s shares were trading at around $77.92. A month later the price is now $52.38. The difference translates to more than $47 billion in market capitalization wiped out in just one month. According to Bloomberg News, this is Charles Schwab’s worst month since the October 1987 stock market crash, known as Black Monday. That day, the Dow Jones index lost 508 points, a decline of 22.6% and the largest daily decline in a stock market index at the time. Only the drop by 76% of the Icelandic stock market in 2008 would exceed this record.
VERSUS
With the first quarter of 2023 behind us, and despite wild fluctuation due to continuous rate hikes from the Fed and an unexpected bank panic, stocks and bonds managed to turn in a pretty, pretty, pretty good performance for the quarter. The S&P 500 gained 7%, and the Dow Jones Industrial Average gained 0.4%. But if the market’s metaphorical report card is impressive, tech companies were indisputably the honors students.
Wall Street rewarded tech companies’ layoffs and other cost cutting measures, giving tech stocks a resurgence. And with ChatGPT becoming a household name, investors have their money on generative AI as the next big bet. As of last night:
The tech-heavy NASDAQ Composite index rose a whopping 18% since January 1, its largest quarterly gain in two years.
Stocks of the tech giants leading the charge in AI-powered search, Microsoft and Alphabet, are up 20% and 16%, respectively.
Bank stocks were a delight for short sellers, who made $2 billion betting against the sector in the past three months.
Smaller institutions were most badly injured by the bank panic: The SPRD S&P Regional Banking ETF, which consists of non-behemoth banks, had more than a quarter of its value wiped out in Q1.
Large banks are feeling the pinch of rising interest rates: Global merger and acquisition deals suffered the biggest first-quarter decline since 2001, according to data analyzed by the Financial Times.
Posted on April 1, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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April Fools’ Day—occurring on April 1 each year—has been celebrated for several centuries by different cultures, though its exact origins remain a mystery. April Fools’ Day traditions include playing hoaxes or practical jokes on others, often yelling “April Fools!” at the end to clue in the subject of the April Fools’ Day prank. While its exact history is shrouded in mystery, the embrace of April Fools’ Day jokes by the media and major brands has ensured the unofficial holiday’s long life.
Investors celebrated a lower-than-expected reading on the Federal Reserve’s preferred inflation gauge by driving major U.S. stock indexes higher Friday, the last trading day of the first quarter. Sentiment got a boost after reports that the personal consumption expenditures (PCE) index rose 0.3% in February, a little below the 0.4% economists were expecting, and 5% from the same month a year ago. Core PCE inflation, which excludes volatile food and inflation prices, was also up 0.3% from the previous month and 4.6% from a year earlier. PCE and core PCE both rose 0.6% in January from the month before.
Despite wild fluctuation due to continuous rate hikes from the Fed and an unexpected bank panic, stocks and bonds managed to turn in a pretty, pretty, pretty good performance for the quarter. The S&P 500 gained 7%, and the Dow Jones Industrial Average gained 0.4%.
But, tech companies were indisputably the market leaders.
Wall Street rewarded tech companies’ layoffs and other cost cutting measures, giving tech stocks a resurgence. And with ChatGPT becoming a household name, investors have their money on generative AI as the next big bet. As of last night:
The tech-heavy NASDAQ Composite index rose a whopping 18% since January 1st, its largest quarterly gain in two years.
Stocks of the tech giants leading the charge in AI-powered search, Microsoft and Alphabet, are up 20% and 16%, respectively.
Bank stocks were a delight for short sellers, who made $2 billion betting against the sector in the past three months.
Smaller institutions were most badly injured by the bank panic: The SPRD S&P Regional Banking ETF, which consists of non-behemoth banks, had more than a quarter of its value wiped out in Q1.
Large banks are feeling the pinch of rising interest rates: Global merger and acquisition deals suffered the biggest first-quarter decline since 2001, according to data analyzed by the Financial Times.
“The 0.3% monthly increase in core PCE was a step in the right direction but suggests the path to 2% inflation will still likely be long and bumpy,” says Collin Martin, a fixed income strategist at the Schwab Center for Financial Research.
The S&P 500 Index rose 58 points (1.44%) to 4109.05; the Dow Jones industrial average was up 415 points (1.26%) at 33274.15; the NASDAQ Composite was up 208 points (1.74%) at 12221.91.
The 10-year Treasury yield slipped seven basis points to 3.482%.
CBOEs Volatility Index was down 22 basis points (1.16%) at 18.78.
Posted on April 1, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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Medicare Advantage (MA) plans, also known as Part C plans, serve as a supplement or an alternative to Original (also called Traditional) fee-for-service (FFS) Medicare Part A and Part B coverage, but they are still part of the Medicare program.
Most of these plans also include Part D (drug) coverage. MA was created by Congress to offer seniors an alternative to Original Medicare – with an emphasis on treating and managing the health of the whole patient. MA plans are offered to Medicare beneficiaries by Medicare-approved private companies, known as MA Organizations (MAOs), that must follow rules set by Medicare. (Read more…)
Posted on March 31, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Analysts at Morgan Stanley downgraded Charles Schwab Corp (NYSE: SCHW) on Tuesday, citing concerns over cash sorting and regulatory changes. But, Schwab CEO Walt Bettinger recently said that the company’s banking unit had enough liquidity to cover if 100% of its bank deposits ran off without having to sell a single security — Morgan Stanley says otherwise. Schwab’s recent performance has not been up to Morgan Stanley’s expectations, with customers moving cash out of sweep accounts into money market funds at a rate twice that which the bank had been modeling.
The S&P 500® Index rose 23 points (0.57%) to 4050.84; the Dow Jones industrial average was up 141 points (0.43%) at 32859.03; the NASDAQ Composite was up 87 points (0.73%) at 12013.47.
The 10-year Treasury yield slipped 2 basis points to 3.555%.
CBOE’s Volatility Index was little changed at 19.14.
Posted on March 30, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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CVS expects to finalize its $8 billion acquisition of Signify Health this week, the retail pharmacy giant said yesterday. CVS beat out both Amazon and UnitedHealth Group to buy Signify, a value-based provider network. The company announced the deal last September, and executives said they expect it to close “on or around March 29th.”
In a phone call following the deal announcement, Shawn Guertin, EVP and CFO at CVS, said the company anticipates that acquiring Signify will “generate attractive returns” for CVS. The acquisition strengthens CVS’s goal of becoming a value-based healthcare company and could give it a leg up over rival Walgreens. Both companies have doubled down on value-based care in the last couple of years, making several multi-billion dollar deals, such as Walgreens’s $5.2 billion VillageMD acquisition in 2021 and CVS’s $10.6 billion takeover of Oak Street Health.
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The U.S. Food and Drug Administration has approved NARCAN, an overdose-reversing nasal spray, for over-the-counter, non-prescription sale, the agency just announced. The FDA green light marks the first naloxone product approved for use without a prescription. Naloxone rapidly reverses the effects of an opioid overdose, including situations where fentanyl is involved. In the 12-month period ending in October 2022, the United States recorded 101,750 overdose deaths, primarily from opioids including fentanyl, according to the FDA.
“Today’s action paves the way for the life-saving medication to reverse an opioid overdose to be sold directly to consumers in places like drug stores, convenience stores, grocery stores and gas stations, as well as online,” the agency said in a news release.
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Here’s how the major indexes performedyesterday:
The S&P 500® Index rose roughly 57 points (1.42%) to 4027.83; the Dow Jones industrial average was up 323 points (1.0%) at 32717.73; the NASDAQ Composite was up 210 points (1.79%) at 11926.24.
The 10-year Treasury yield was little changed at 3.575%.
CBOEs Volatility Index was down 80 basis points (4.01%) at 19.17.
Posted on March 29, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Markets: The NASDAQ stumbled for the second straight day as rising bond yields banged up the tech sector, which is ultrasensitive to higher interest rates.
Alibaba: Shares in the Chinese e-commerce giant popped after it announced the most extreme restructuring in its history: It’s going to split up into six business units (“mini Alibabas”) that could each go IPO separately.
Et Cetera and More
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AMC stock popped 13% after a report from The Intersect claimed Amazon was considering buying the theater chain.
Lucid, the EV startup, is laying off ~18% of its workforce, or around 1,300 employees.
Disney has cut its metaverse division as part of 7,000 layoffs, according to the WSJ.
McKinsey, the consulting firm that usually recommends layoffs at other companies, is cutting about 1,400 roles from its own roster.
Substack is allowing writers on its platform to buy shares in the company for as little as $100. Substack has already raised $82 million in venture capital.
Posted on March 28, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A rare alignment of five planets will be visible in the night sky this week, but this Tuesday [tonight] evening will be your best bet. Just head outside right after sunset, look west, and you’ll see Mercury, Venus, Mars, Jupiter, and Uranus appear to line up in an arc shape below the crescent moon. Anyone on Earth should be able to see it, even if you’re living in a city with light pollution.
The word syzygy is often used to describe interesting configurations of astronomical objects in general. For example, one such case occurred on March 21, 1894, around 23:00 GMT, when Mercury transited the Sun as would have been seen from Venus, and Mercury and Venus both simultaneously transited the Sun as seen from Saturn. It is also used to describe situations when all the planets are on the same side of the Sun although they are not necessarily in a straight line, such as on March 10, 1982.
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Here’s how the mixed markets fared yesterday on Monday:
The S&P 500® Index was up 6.54 points (0.16%) at 3977.53; the Dow Jones industrial average was up 194.55 points (0.6%) at 32432.08; the NASDAQ Composite was down 55.12 points (0.47%) at 11768.84.
The 10-year Treasury yield was up around 17 basis points at 3.542%.
CBOEs Volatility Index was down 1.05 points (4.8%) at 20.71.
Outside of the financial sector, energy also had a good day Monday, as the apparent return to calm in the world of banks helped ease concerns about the economy. Oil prices recovered, with West Texas Intermediate rising more than 5% to roughly $73.
Posted on March 27, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Ark’s Back-to-Back Sale: Ark Invest’s Ark Innovation ETF (NYSE: ARKK) and Ark Next Generation Internet ETF (NYSE: ARKW) sold 119,151 and 11,547 shares of Tesla, respectively, on Friday, daily trade information from the company showed. Friday’s disposals totaled 130,698 shares, valued at $24.98 million. On Thursday, Ark’s ARKK and ARKW cumulatively sold 139,000 shares valued at $26.8 million. Wood’s firm divested $51.78 million worth of Tesla stock this week.
Ark has been a buyer of Tesla shares since the stock’s decline late last year. The last sale by the firm ahead of this past week’s liquidation was in early September. 2022. On the other hand, Elon Musk is reportedly handing out stock awards to Twitter employees at a valuation of ~$20 billion. He bought the company for $44 billion last year.
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SVB was finally sold. Well, at least a large portion of it. First Citizens BancShares, a Raleigh-based regional bank, is scooping up SVB’s deposits, loans, and 17 branches that will reopen today under new ownership. About $90 billion of SVB’s assets will remain with the FDIC, which took control of SVB following its epic collapse over two weeks ago. The sale is meant to “instill confidence in the banking system,” the CEO of First Citizens said, and it seems to be working for now: Regional lenders like First Republic Bank are surging premarket.
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