BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on June 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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A POD (Payable on Death) or TOD (Transfer on Death) account is a type of bank account where the account owner names a beneficiary to receive the account assets when the owner dies.
Key points about these accounts include:
Beneficiaries can be anyone, including minors, non-U.S. citizens, and organizations.
The beneficiary needs to provide a certified copy of the deceased’s death certificate to the bank or brokerage firm.
The assets are transferred immediately upon the account owner’s death.
Probate avoidance: By sidestepping probate, POD and TOD accounts streamline the distribution of assets post-death, allowing beneficiaries to gain access to these funds with greater speed.
Simplicity: Setting up these accounts is generally straightforward, often requiring just the completion of a form at the bank or brokerage firm.
No additional cost: There’s usually no cost to establish these accounts, aligning with the needs of individuals seeking a cost-effective method of transferring assets.
Cons
Joint ownership complexity. When an account is jointly owned, the beneficiary of the account won’t receive the assets until the surviving owner(s) die. The same applies to accounts owned in states with tenancy by the entirety for married couples.
Naming alternative beneficiaries: These accounts do not allow for the nomination of alternative beneficiaries if the primary beneficiary or beneficiaries predecease the account owner. This could lead to the assets being subjected to probate if the primary beneficiary is no longer alive at the time of the account holder’s death.
Transfers only happen after death: These accounts stipulate that the person must pass away before the beneficiary can access the funds – a restriction that could prove troublesome if the beneficiary requires access to these assets during the account holder’s life or if the account owner becomes incapacitated during their lifetime.
Posted on June 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Wall Street is stable right now as the technology trade has come roaring back.
The S&P 500 climbed above 6,000 points for the first time since February, while all three indexes posted their fifth winning week in the last seven. The S&P is now just over 2% from its all-time high.
Meanwhile, recent IPOs are party rocking, especially the stablecoin issuer Circle that went public last Thursday.
Many doctors are surprised to learn of an alternative investment known as a hedge fund, pooled investment vehicle or private investment fund. Unlike mutual funds, they can be structured in many ways. However, these funds cannot be marketed or advertised, but they are far from illegal or illicit.
In fact, physicians were among the early investors in one the most successful hedge funds. Warren Buffett got his start in 1957 running the Buffett Partnership, a hedge fund not open to the public. His first appearance as a money manager was before a group of physicians in Omaha, Nebraska. Eleven decided to invest some money with him. A few then followed into Berkshire Hathaway Inc, now among the most highly valued companies in the world.
And, more recently, Scion Asset Management® LLC, is a private investment firm founded and led by my eloquent colleague Michael J. Burry, MD and featured in the movie, The Big Short. Other hedge fund mangers of note include: George Soros, Carl Icahn, Ken Griffin, David Tepper, John Paulson and Bill Ackman.
A hedge fund is a limited partnership of private investors whose money is managed by professional fund managers who use a wide range of strategies; including leveraging [debt] or trading of non-traditional assets [real-estate, collectible, commodities, cyrpto-currency, etc] to earn above-average returns. Hedge funds are considered a risky alternative investment and usually require a high minimum investment or net worth. This person is known as an “accredited investor” or “Regulation D” investor by the US Securities Exchange Commission and must have the following attributes:
A net worth, combined with spouse, of over $1 million, not including primary residence
An income of over $200,000 individually, or $300,000 with a spouse, in each of the past two years
The hurdle rate is part of the fund manager’s performance incentive compensation. Also known as a “benchmark,” it is the amount, expressed in percentage points an investor’s capital must appreciate before it becomes subject to a performance incentive fee. Podiatrists should view the hurdle rate as a form of protection or the fee arrangement.
The hurdle rate benchmarks a single year’s performance and may be considered mutually exclusive of any other year, or the hurdle rate may compound each year. The former case is more common. In the latter case, a portfolio manager failing to attain a hurdle rate in the first year will find the effective hurdle rate considerably higher during the second year.
Once a fund manager attains the hurdle rate, the investor’s capital account may be charged a performance incentive fee only on the performance above and beyond the hurdle rate. Alternatively, the account may be charged a performance fee for the entire level of performance, including the performance required to attain the hurdle rate. Other variations on the use of the hurdle rate exist, and are limited only by the contract signed between the fund manager and the investor. The hurdle rate is not generally a negotiating point, however.
Example: A fund charges a performance fee with a 6 percent hurdle rate, calculated in mutually exclusive manner. A podiatrist places $100,000 with the fund. The first year’s performance is 5 percent. The doctor therefore owes no performance fee during the first year because the portfolio manager did not attain the hurdle rate. During year two, the portfolio manager guides the fund to a 7 percent return. Because the hurdle rate is mutually exclusive of any other year, the portfolio manager has attained the 6 percent hurdle rate and is entitled to a performance fee.
High Water Mark
Some hedge funds feature a “high water mark” provision known as a ”loss-carry forward.” As with the hurdle rate, the high water mark is a form of protection. It is an amount equal to the greatest value of an investor’s capital account, adjusted for contributions and withdrawals. The high water mark ensures that the manager charges a performance incentive fee only on the amount of appreciation over and above the high water mark set at the time the performance fee was last charged. The current trend is for newer funds to feature this high water mark, while older, larger funds may not feature it.
Example: A fund charges a 20 percent performance fee with a high water mark but no hurdle rate. A podiatrist contributes $100,000 to the fund. During the first year, the hedge fund manager grows that capital account to $110,000 and charges a 20 percent performance fee, or $2,000. The ending capital account balance and high water mark is therefore $108,000. During year two, the account falls back to $100,000, but the high water mark remains $108,000. During year three, in order for the manager to charge a performance fee, the manager must grow the capital account to a level above $108,000.
Claw Back Provision
Rarely, a hedge fund may provide investors with a “claw back” provision. This term results in a refund to the investor of all or part of a previously charged performance fee if a certain level of performance is not attained in subsequent years. Such refunds in the face of poor or inadequate performance may not be legal in some states or under certain authorities.
ASSESSMENT
Managers of hedge funds, like colleague Dimitri Sogoloff MBA who is the CEO of Horton Point investment-technology firm, often aim to produce returns that are relatively uncorrelated with market indices and are consistent with investors’ desired level of risk.
While hedging may reduce some risks overall, they cannot all be eliminated. According to a report by the Hennessee Group, hedge funds were approximately one-third less volatile between 1993 and 2010.
For a podiatrist who already holds mutual funds and/or individual stocks and bonds, a hedge fund may provide diversification and reduce overall portfolio risk. Consider investing in them with care.
2. Burry, Michael, J: Hedge Funds [Wall Street Personified]. In, Marcinko, DE and Hetico, HR: Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017.
3. Marcinko, DE and Hetico, HR: Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]. Productivity Press, New York, 2015.
4. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
WHAT YOU “MUST KNOW“ ABOUT FINANCIAL ADVISORY FEES
Investment fees still matter despite dropping dramatically over the past several decades due to computer automation, algorithms and artificial intelligence, etc. And, they can make a big difference to your financial health. So, before buying any investment, it’s vital to uncover all real financial advisor and stock broker costs.
1. Up-front salesperson commissions. It is easy to ask; “If I buy this investment today and want to get out tomorrow, how much money do I get back?” If the answer is not “all your money,” the difference is probably upfront fees and commissions. These fees may run as high as 30% of the money invested. If you were to earn 5% a year on the investment, it would take 8 years just to break even.
2. Ongoing advisory fees. These are monthly, quarterly, or annual fees paid to advisors for their investment advice and oversight. This includes working with you to pick the asset classes, set diversification, select a portfolio manager, optimize taxes, re-balance holdings and other periodic tasks.
These fees have many names including wrap fee or investment advisory fees. The normal “rule of thumb” is 1% of assets managed, although fees can range from 0 to 7%. Today, it can even be as low as .5%. It can be charged even if the advisor receives an upfront commission. It can be easy to see, or hidden in the fine print.
3. Additional service fees. Find out specifically what services are included financial advisory fees. Additional fees for financial planning or other services are rarely disclosed. They can range from minimal hand-holding focused on your investments to comprehensive financial planning.
4. Ongoing managerial expense ratio fees. These are incredibly well hidden that you may not see them in your statements or invoices. The only way to know is to read the prospectus or other third party analysis, like Morningstar.com. And, they can vary greatly for the same investment, depending on the class of share you buy.
For example, American Fund’s New Perspective Fund’s expense ratio ranges from 0.45% to 1.54%. The average expense ratio of a mutual fund that invests in stocks is 1.35%. Conversely, the average expense ratio of a Vanguard S&P 500 Fund is 0.10%. The difference of 1.25% is staggering over time.
5. Miscellaneous fees. Some advisors charge $50 – $100 a year per account to open or close an account, and even fees to dollar cost average your funds into the market.
6. Transaction fees. Every time you buy or sell a fund, a fee is typically paid to a custodian. These can range from $5 to hundreds of dollars per transaction.
7. Fee Only: Paid directly by clients for their services and can’t receive other sources of compensation, such as payments from fund providers. Act as a fiduciary, meaning they are obligated to put their clients’ interests first
8. Fee Based: Paid by clients but also via other sources, such as commissions from financial products that clients purchase. Brokers and dealers (or registered representatives) are simply required to sell products that are “suitable” for their clients.
A “suitable” investment is defined by FINRA as one that fits the level of risk that an investor is willing and able, as measured by personal financial circumstances, to take on. The Financial Industry Regulatory Authority is a private American corporation that acts as a Self Regulatory Organization (SRO) that regulates member stock brokerage firms and exchange markets. These criteria must be met. It is not enough to state that an investor has a risk-friendly investment profile. In addition, they must be in a financial position to take certain chances with their money. It is also necessary for them to
A hedge fund is a limited partnership of private investors whose money is managed by professional fund managers who use a wide range of strategies; including leveraging [debt] or trading of non-traditional assets [real-estate, collectible, commodities, cyrpto-currency, etc] to earn above-average returns. Hedge funds are considered a risky alternative investment and usually require a high minimum investment or net worth. This person is known as an “accredited investor” or “Regulation D” investor by the US Securities Exchange Commission and must have the following attributes:
A net worth, combined with spouse, of over $1 million, not including primary residence
An income of over $200,000 individually, or $300,000 with a spouse, in each of the past two years
Choose the fee structure. The fee structure should align with your needs. Consider the type of advice you seek, the number of times needed and the complexity of your financial situation. You can always negotiating tactics are free to ask for a better deal.
Compare fees. It is essential to research and compare different fees. Be sure to read the fine print for details or costs that are not a base fee.
Robo-advisors: For simple investment goals, with little specificity, robo-advisors may be a cost-effective option. They charge lower fees than conventional financial advisors and provide an automated, algorithmic approach to managing your investments.
Assessment
The average cost of working with a human financial advisor in 2024 was 0.5% to 2.0% of assets managed, $200 to $400 per hourly consultation, a flat fee of $1,000 to $3,000 for a one-time service, and/or a 3% to 6% commission fee on the product types sold.
When ruminating over financial advisory fees; read and understand the contract with disclosures, do not sign a confidentiality or non-disclosure agreement, and do not waive your right to a lawsuit. According to colleague Dr. Charles F. Fenton IIII JD, forced legal settlements almost always favor the advisor over the client.
2. Marcinko, DE and Hetico, HR; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017.
3. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Stocks: The S&P 500 touched 6,000 points for the first time since February and wrapped up its fifth positive week in the past seven following a better-than-expected jobs report. The vibes got even better in the afternoon following a President Trump announcement that the US and China trade teams will meet in London on Monday. STOCKS: https://medicalexecutivepost.com/2025/04/18/stocks-basic-definitions/
Bonds: Treasury yields ticked up in response to the solid May jobs report, a sign that investors were reducing bets on the scale of rate cuts this year. That’s not what Trump wants to hear: He urged Fed Chair Jerome Powell to slash interest rates by a jumbo-sized full point to pour “rocket fuel” on the economy. REVENUE BONDS: https://medicalexecutivepost.com/2024/12/20/bonds-revenue/
Oil: Oil prices have gone sideways for three straight weeks now, trading within a $4 range around $65/barrel since the middle of May. We’ll let you know when something interesting happens. CRUDE OIL:https://medicalexecutivepost.com/2024/08/14/wti-crude-oil/
Posted on June 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
BREAKING NEWS
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Job growth is slowing, but still bigger than expected
US employers added 139,000 jobs last month, government data released yesterday shows—that’s less than the down-wardly revised 147,000 new jobs that were added in April, but more than economists had predicted. Meanwhile, the unemployment rate held steady.
Overall, the highly anticipated jobs report reflects employers growing more cautious in the face of the economic uncertainty brought on by the trade war, but so far, there doesn’t seem to be a steep drop off in the labor market. That could give the Fed reason to stay in wait-and-see mode on interest rates, though President Trump still used the occasion to urge Jerome Powell to cut rates “a full point” on Truth Social.
Markets: Stocks fell yesterday as investors readied themselves for today’s jobs report. The May jobs report is expected to show hiring slowed while the unemployment rate held flat. The data release will come as investors closely watch for any further signs of slowing in the US labor market.
The Bureau of Labor Statistics data is slated for release at 8:30 a.m. ET, today. Economists expect non-farm payroll to have risen by 125,000 in May and the unemployment rate to have held steady at 4.2%, according to consensus estimates compiled by Bloomberg.
Posted on June 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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On April 11th, 2025, the Centers for Medicare & Medicaid Services (CMS) released its proposed rules for the payment and policy updates for the Medicare inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) for fiscal year (FY) 2026.
This Health Capital Topics article will discuss the proposed rule and the implications for stakeholders. (Read more…)
As many medical, dental and podiatric colleagues are aware, Environmental, Social and Governance (ESG) investing refers to a set of standards for a company’s behavior used by socially conscious investors to screen potential investments. Over the last decade, or so, I have seen many investors pursing this laudable aim.
Yet, more than 80% of private equity fund managers have now stepped away from at least one deal due to ESG concerns, according to the 2023 BDO Private Capital Survey. The reasons are complex, and point towards fund managers’ sentiment towards risk-reward in the current economic environment.
This retreat from ESG is due to backlash from conservatives who are critical of the idea that mutual fund managers should be considering any other factor but a company’s share holders in their investment decisions. Accusations of “Greenwashing” have also plagued many ESG funds, which is when an asset management firm charging higher fees or a specific thematic fund without actually delivering a unique investment strategic competitive advantage.
Greenwashing is the process of conveying a false impression or misleading information about how a company’s products are environmentally sound. Greenwashing involves making an unsubstantiated claim to deceive consumers and / or investors into believing that a company’s products are environmentally friendly or have a greater positive environmental impact than they actually do. Greenwashing may also occur when a company attempts to emphasize sustainable aspects of a product to overshadow the company’s involvement in environmentally damaging practices.
According to internationally known linguistics and cognitive science Professor,Mackenzie Hope Marcinko PhD of the University of Delaware, greenwashing is performed through the use of environmental imagery, misleading labels, cognitive biases and tendencies hiding tradeoffs. Greenwashing is also a play on the term “Whitewashing,” which means using false information to intentionally hide wrongdoing, errors or an unpleasant situation in an attempt to make it seem less bad than it really is.
To be sure, uncertainty around ESG regulations in the USA is leading financial deal makers to tread carefully. For example, Jim ClaytonMBA, aprivate equity advisor also from the University of Delaware recently stated:
“We’re a year past when the SEC said they were going to issue ESG reporting standards for public filers which has created more noise in the system.”
“People are nervous about what I would call ESG-intense exposed industries, in other words, those with “heavy carbon footprints”.
And, a federal judge in Texas said that American Airlines violated federal law by basing investment decisions for its employee retirement plan on environmental, social, and other non-financial factors. The ruling in January 2025 by US District Judge Reed O’Connor appeared to be the first of its kind amid growing backlash by conservatives to an uptick in socially-conscious investing. O’Connor said American had breached its legal duty to make investment decisions based solely on the financial interests of 401(k) plan beneficiaries by allowing BlackRock, its asset manager and a major shareholder, to focus on environmental, social and corporate governance (ESG) factors.
Even the State of Florida pulled $2 billion from the investment management firm BlackRock in the largest divestment ever made. Florida Governor Ron DeSantis claimed that by taking ESG standards into account when making investment decisions, the firm isn’t prioritizing the financial bottom line for Floridians.
Assessment
But, for a few years at least, things were indeed good. In 2020 and 2021, ESG funds outperformed the market by ~4.3%.
Conclusion
So, always remember [caveat emptor]: let the buyer beware!
2. Marcinko, DE; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017
3. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on June 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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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.
HealthEquity jumped 8.96% after the health savings account custodian boosted its fiscal guidance for the year ahead.
What’s down
Tesla tumbled 3.55% on weak sales data from China and Germany.
Apple fell 0.22% thanks to a downgrade from Needham analysts, who think the company’s valuation is way too high.
Wells Fargo lost 0.36% after the Federal Reserve lifted its 2018 cap on the bank’s assets.
What goes up must come down: ConstellationEnergy sank 4.31% after Citigroup downgraded the nuclear power provider, warning it’s not getting its money’s worth with Meta Platforms.
Asana plunged 20.47% after the work management software maker announced fiscal forecasts that came in below Wall Street’s expectations.
Flowserve lost 6.27% and ChartIndustries dropped 9.46% after the two industrial manufacturers agreed to an all-stock merger of equals.
50% tariffs on steel and aluminum went into effect today. To celebrate, President Trump hopped on Truth Social to put China’s President Xi on blast ahead of an expected call between the two heads of state. And, Temu lost 58% of its daily users thanks to tariffs.
The president also pushed Jerome Powell to “LOWER THE RATE” following terrible private sector job numbers. Stocks are seemingly immune to tough trade talk and interest rate rants at this point, but bond yields sank on fears of slower economic growth.
The US dollar slipped, propelling gold higher as investors sought safety.
A proxy statement tells you a lot about a company’s management and board of directors, providing details about compensation, large shareholders, and the accounting firm that audits the company books. It also includes information about shareholder resolutions and the board’s responses to those proposals.
Each publicly traded company files a proxy statement with the Securities and Exchange Commission (SEC) every year, and it’s used by shareholders to help cast votes on their proxy ballots. The board may provide recommendations to vote for or against a proposal, but investors should do their best to collect the facts and make a decision on their own.
According to Motley Fool, about once every year, for most companies, you will have the right to vote your shares on a variety of topics related to the companies you own in your portfolio. These are called proxy votes. Regular individual shareholders generally receive one vote per share owned. Some companies have multiple classes of shares, and management and other insiders will have a higher level of voting power (for example, 10 votes per share).
Every year, you will receive a proxy statement in the mail or electronically. This document gives you insight into a variety of important issues to consider and vote on using your proxy ballot.
Posted on June 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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A recent joint report by the National Association of Accountable Care Organizations (NAACOS) and Innovaccer Inc., a healthcare artificial intelligence (AI) company, found tangible evidence that the U.S. healthcare delivery system is indeed moving toward value-based care (VBC).
Fifteen years after the passage of the Patient Protection and Affordable Care Act (ACA), which promoted VBC through the advent of ACOs and other alternative payment models, there is finally evidence that providers are actually moving in that direction.
This Health Capital Topics article reviews the joint report on “The State and Science of Value-based Care 2025.”(Read more…)
According to wikipedia, the S&P 500 Dividend Aristocrats is a stock market index composed of the companies in the S&P 500 index that have increased their dividends in each of the past 25 consecutive years. It was launched in May 2005.
There are other indexes of dividend aristocrats that vary with respect to market cap and minimum duration of consecutive yearly dividend increases. Components are added when they reach the 25-year threshold and are removed when they fail to increase their dividend during a calendar year or are removed from the S&P 500. However, a study found that the stock performance of companies improves after they are removed from the index The index has been recommended as an alternative to bonds for investors looking to generate income.
To invest in the index, there are several exchange traded funds (ETFs), which seek to replicate the performance of the index.
A donor-advised fund is a private account created to manage and distribute charitable donations on behalf of an organization, family, or individual. Donor-advised funds can democratize philanthropy by aggregating the contributions of multiple donors, thus multiplying their impact on worthy causes. Donor-advised funds also have abundant tax advantages.
Donor-advised funds have become increasingly popular, as they offer the donor greater ease of administration while still allowing them to maintain significant control over the placement and distribution of charitable gifts. But, unlike private foundations, donor-advised fund holders enjoy a federal income tax deduction of up to 60% of adjusted gross income (AGI) for cash contributions and up to 30% of AGI for the appreciated securities they donate. Donors to these funds can contribute cash, stock shares, and other assets. When they transfer assets such as limited-partnership interests, they can avoid capital gains taxes and receive immediate fair market value tax deductions.
According to the National Philanthropic Trust’s 2023 Donor-Advised Fund Report, these funds have continued to grow in recent years, despite some headwinds including the Covid-19 pandemic and occasional stock market setbacks. Total grants awarded by donor-advised funds in 2022 increased by 9% to $52.16 billion, while total contributions rose by 9% to $85.5 billion.
Many donor-advised funds accept non-cash assets—such as checks, wire transfers, and cash positions from a brokerage account—in addition to cash and cash equivalents.
Donating non-cash assets may be more beneficial for individuals and businesses, leading to bigger tax bigger write-offs.
Posted on May 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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What Is a SAFE Note?
A SAFE note is a type of convertible security that specifies a certain amount of money an investor will pay you as a business owner. In exchange, you agree to give the investor a certain amount of equity in your company at an agreed-upon future date. In other words, a SAFE note confers the right for an investor to purchase shares in your company in a future-priced round.
How SAFE Notes Work
According to ContractsCounsel, a SAFE note works in the following way:
An investor provides funding in exchange for the right to future equity.
You use the funding to grow your business.
After your company grows sufficiently, you secure another investor, and your company receives a “post-money valuation.”
You calculate your company’s price per share.
You convert the SAFE note into the applicable number of shares and distribute them to the SAFE investor. Typically, a SAFE note converts after an equity financing round.
Example of a SAFE Note
An investor purchases a SAFE note with a valuation cap of $20 million. During the next funding round, the value of your company is set at $40 million at $20 a share. Because the SAFE note has a valuation cap of $20 million, its owner can purchase twice as many shares of your company as new investors can. This was the incentive for the SAFE investor to provide funding earlier.
Within venture capital financing, a convertible note is a type of short-term debt financing that’s used in early-stage capital raises. In other words, convertible notes are loans to early-stage startups from investors who are expecting to be paid back when their note comes due. But, instead of being paid back in principal with interest—as would be the case with a typical loan—the investor can be repaid in equity in your company.
You might also think of a convertible note like an IOU. An investor provides you with capital now and the convertible note, acting as a short-term loan, ensures that you give the investor a stake in your startup later. From the investor’s point of view, the benefit in this exchange is that if they give you capital and a vote of confidence early on and you do well, you’ll repay them many times over.
How Do Convertible Notes Work?
Typically, an investor will provide an early-stage startup in need of capital with a loan (with repayment terms in the ballpark of a standard short-term loan, usually a year or two), along with repayment terms. This is the “note.” The note will include a due date at which time it’s mature and the balance will be due, along with interest. Generally, however, the note is not repaid like a normal short-term loan. Instead, you repay the investor for their loan with equity in your company, usually in conjunction with another funding round.
If, however, the maturity date comes along and your startup has not yet converted the note to equity, the investor can either extend the convertible note’s maturity date or call for the actual repayment of the note.
This being said, the whole idea behind convertible notes is that your company is on a strong growth trajectory and that is why the note is being issued—it amasses value for the investor and beelines to a priced round. Ultimately, the point of a convertible note is that the noteholder, or investor, doesn’t want to get their loan paid back— they want their debt to convert into a heavily discounted security in a successful, valuable company that’s growing extremely quickly.
Cons: The major downside of a convertible note is that you will eventually be giving up some control over your business. When the convertible note comes due, the investor will be granted equity in your business. If you’re not ready to split ownership of your business with outside parties, this is not the right financing option for you.
Posted on May 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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The terms “real estate agent” and “realtor” are often used interchangeably to describe a licensed professional who can help you buy or sell a home. But the terms have different meanings.
A realtor is a licensed salesperson who belongs to the National Association of Realtors (NAR), and must comply with NAR’s code of ethics. The term is capitalized when describing a NAR member, and NAR owns the trademark.
A real estate agent is simply a licensed salesperson who does not belong to NAR, and refers to any individual who holds a real estate salesperson’s license.
Should you hire a real estate agent or a realtor? Agents who belong to NAR aren’t necessarily better than non-member agents. NAR is just a trade association — not a licensing body — so membership is optional.
Life planning and behavioral finance as proposed for physicians and integrated by the Institute of Medical Business Advisors Inc., is unique in that it emanates from a holistic union of personal financial planning, human physiology and medical practice management, solely for the healthcare space. Unlike pure life planning, pure financial planning, or pure management theory, it is both a quantitative and qualitative “hard and soft” science, with an ambitious economic, psychological and managerial niche value proposition never before proposed and codified, while still representing an evolving philosophy. Its’ first-mover practitioners are called Certified Medical Planners™.
Financial Life Planning is an approach to financial planning that places the history, transitions, goals, and principles of the client at the center of the planning process. For the financial advisor or planner, the life of the client becomes the axis around which financial planning develops and evolves.
Financial Life Planning is about coming to the right answers by asking the right questions. This involves broadening the conversation beyond investment selection and asset management to exploring life issues as they relate to money.
Financial Life Planning is a process that helps advisors move their practice from financial transaction thinking, to life transition thinking. The first step is aimed to help clients “see” the connection between their financial lives and the challenges and opportunities inherent in each life transition.
But, for informed physicians, life planning’s quasi-professional and informal approach to the largely isolate disciplines of financial planning and medical practice management is inadequate. Today’s practice environment is incredibly complex, as compressed economic stress from HMOs managed care, financial insecurity from insurance companies, ACOs and VBC, Washington DC and Wall Street; liability fears from attorneys, criminal scrutiny from government agencies, and IT mischief from malicious electronic medical record [eMR] hackers. And economic bench marking from hospital employers; lost confidence from patients; and the Patient Protection and Affordable Care Act [PP-ACA] more than a decade ago. All promote “burnout” and converge to inspire a robust new financial planning approach for physicians and most all medical professionals.
The iMBA Inc., approach to financial planning, as championed by the Certified Medical Planner™ professional certification designation program, integrates the traditional concepts of financial life planning, with the increasing complex business concepts of medical practice management. The former topics are presented in this textbook, the later in our recent companion text: The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors].
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For example, views of medical practice, personal lifestyle, investing and retirement, both what they are and how they may look in the future, are rapidly changing as the retail mentality of medicine is replaced with a wholesale and governmental philosophy. Or, how views on maximizing current practice income might be more profitably sacrificed for the potential of greater wealth upon eventual practice sale and disposition.
Or, how the ultimate fear represented by Yale University economist Robert J. Shiller, in The New Financial Order: Risk in the 21st Century, warns that the risk for choosing the wrong profession or specialty, might render physicians obsolete by technological changes, managed care systems or fiscally unsound demographics. OR, if a medical degree is even needed for future physicians?
Say, what medical license?
Dr. Shirley Svorny, chair of the economics department at California State University, Northridge, holds a PhD in economics from UCLA. She is an expert on the regulation of health care professionals who participated in health policy summits organized by Cato and the Texas Public Policy Foundation. She argues that medical licensure not only fails to protect patients from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible. Institutional oversight and a sophisticated network of private accrediting and certification organizations, all motivated by the need to protect reputations and avoid legal liability, offer whatever consumer protections exist today.
Yet, the opportunity to revise the future at any age through personal re-engineering, exists for all of us, and allows a joint exploration of the meaning and purpose in life. To allow this deeper and more realistic approach, the informed transformation advisor and the doctor client, must build relationships based on trust, greater self-knowledge and true medical business management and personal financial planning acumen.
[A] The iMBA Philosophy
As you read this ME-P website, we hope you will embrace the opportunity to receive the focused and best thinking of some very smart people. Hopefully, along the way you will self-saturate with concrete information that proves valuable in your own medical practice and personal money journey. Maybe, you will even learn something that is so valuable and so powerful, that future reflection will reveal it to be of critical importance to your life. The contributing authors certainly hope so.
At the Institute of Medical Business Advisors, and thru the Certified Medical Planner™ program, we suggest that such an epiphany can be realized only if you have extraordinary clarity regarding your personal, economic and [financial advisory or medical] practice goals, your money, and your relationship with it. Money is, after only, no more or less than what we make of it.
Ultimately, your relationship with it, and to others, is the most important component of how well it will serve you.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com
Posted on May 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Rick Kahler MSFP CFP®
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OVER HEARD IN THE FINANCIAl ADVISOR’S LOUNGE
A basic strategy for asset protection is to hold various assets in different entities. Putting real estate, small businesses, and other assets into trusts, corporations, or limited liability companies (LLCs) is effective protection that is relatively easy to put into practice. Not only do I recommend this strategy to clients, I use it myself. Recently, however, I discovered a potential downside.
About 25 years ago, I invested in some rare coins in a corporation I owned and put them into a safe deposit box owned by the corporation. When my business relocated 12 years ago, the safe deposit box billing was not forwarded to the new address and was never paid again. Last year I went to retrieve the coins from the safe deposit box, which I had not visited in 25 years. I discovered the box had been drilled open three years earlier and my collection turned over to the unclaimed property division of the State Treasurer’s office.
I was told getting the coins back would be simple enough. I just needed to verify that I owned the company which owned them by providing the corporation’s tax ID number. However, the corporation no longer existed. I didn’t have a record of its tax ID number. The IRS wouldn’t verify the number without my giving them the address the company had used. That address was a post office box number that I no longer used and couldn’t remember. The state’s position was “no tax ID, no coins.” The only verification of my identity as owner of the corporation was my signature on the bank’s safe deposit box application. Eventually, with the support of bank officers who were willing to swear that I was who I claimed to be, I got my coin collection back. The hassle involved in this process was a reminder of an important component of asset protection. Maintain accurate records so you don’t end up hiding assets from yourself.
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A good start is to create a master file of all the entities that hold your assets. This can be any system that’s easy for you to use: a computer spreadsheet, a set of file folders, or a single paper list. Share it as appropriate with your CPA, attorney, or financial planner. The master list should include the name of each company, its date of incorporation, tax ID number, address, and other relevant information like phone or bank account numbers. Also keep an inventory of the assets each company owns.
Once you’ve created a master list, it’s essential to keep it up to date as you buy or sell assets, close companies, or transfer ownership. Set up a system, as well, to remind yourself of tasks like filing tax returns, completing minutes of annual meetings, and paying the annual safe deposit box rent. Make your record-keeping easier by eliminating unnecessary complications.
For example, you probably don’t need a separate address for each trust, corporation, or LLC. Instead of creating a separate company for each asset, you might consider grouping smaller assets within one entity. I’d suggest first discussing the pros and cons with an attorney or financial planner. For larger assets like real estate, I do recommend holding each one separately.
When I talk to clients about asset protection, I mention that part of the price we pay for it is an increase in paperwork. It’s easy to accept that idea with casual good intentions. The case of my reclaimed coin investment is a good reminder of the importance of keeping up with that paperwork. If we don’t, we might protect ourselves right out of access to our own assets.
Posted on May 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
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Stock markets are coming off their worst week since April as President Trump’s tariff threats on Europe and Apple revived trade war jitters. The president has since delayed tariff threats on the EU, giving European stocks a boost yesterday, while Wall Street had the day off for Memorial Day.
No such relief appears to be coming for Apple, which has fallen 8% so far this month, and is the only Magnificent Seven member in the red for May, per FactSet.
Most individual physician portfolios are simply a list of stocks. Doctors with such lists usually know the cost of each position and when they acquired it. It is not unusual to find inherited low cost stocks in the account that have been held for many years.
When you inherit securities, a new cost basis is established (the price of the stock on the date of death or six months later—the executor of the estate makes this determination). Even though there would be no capital gain liability if the stock were sold immediately after date of death, most people simply don’t do anything, just hold the stock. Of course taxes should be considered when selling securities but the investment merit should be the overriding factor.
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Doctor and Accountant Opinions
In a personal communication, Mr. L. Eddie Dutton, CPA said, “First make an investment decision and if it fits into the tax plan, so much the better. Doctors often wonder where they will get the money to pay the taxes. I say to get it from the sale of the appreciated stock and cry all the way to the bank with your profit.”
Dr. Ernest Duty MD, a very successful private investor advises “Ask yourself this question: If you had the money instead of the stock, would you buy the stock? If your answer is ‘Yes’ then, hold on to the stock but if you say ‘No, I wouldn’t buy that stock today’ then, sell it” [personal communication].
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: E-MAILCONTACT: MarcinkoAdvisors@outlook.com
If you stash $100,000 in cash under your mattress in three decades, you might not have lost a single dollar, but the value of your money has undoubtedly gone down over time.
Because of inflation, each dollar will buy you less and less over time—your purchasing power decreases. In this sense, time is cruel to the value of money and today’s dollar is worth more than tomorrow’s.
Example: A young physician investor can invest less money over a longer period of time than an older investor who invests more money over a shorter period and ends up with more in the end. Compounding returns grow exponentially, making time more than an ally – but a force of the universe driving growth. Time is certainly our ally in investing, but you’ll kick yourself wishing you had invested earlier when you witness compounding after a few years (or a decade).
Giving circles support with their dollars, but also build awareness, volunteer, become board members and more. Individuals multiply their impact and knowledge, have fun, and connect with their local community.
People are coming together around the world to create the change they want to see in the world. Giving circles are a growing global movement with more than 2,500 active circles around the world giving intentionally and thoughtfully.
Posted on May 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters and AI
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What is a cashier’s check?
Unlike a personal check, a cashier’s check is guaranteed by a bank, drawn from the bank’s own funds, and signed by a bank representative. It’s typically used for large or important transactions, such as buying a car or making a down payment on a home, because it offers more security to the recipient than a personal check.
Traditionally, bank customers obtain a cashier’s check by visiting a bank or credit union in person. There’s usually no limit on the amount of the cashier’s check as long as you have the money to cover it. You and the bank or credit union representative sign the check, and the money is withdrawn from the financial institution’s funds when the check is cashed. However, some online banks may allow you to order a cashier’s check online or over the phone.
If you need a cashier’s check the same day and your bank doesn’t have physical branches, a credit union in your area might issue cashier’s checks even if you’re not a customer. Otherwise, consider signing up with a bank or credit union with physical branches in your area.
There is typically a fee to get a cashier’s check, though the amount isn’t significant. Often, you’ll pay less than $20 even for cashier’s checks of several thousand dollars. The relatively low fees for cashier’s checks and guarantee of funds make them useful when making large, important transactions.
A money order is another paper payment method similar to a check. You pay the amount up front (usually in cash or debit), plus a small fee, and the issuer prints a money order that can be filled out to a specific recipient. Because the payment is prepaid, money orders are considered a safe alternative to personal checks, especially for smaller transactions or when sending money through the mail.
Money orders are available at many banks and credit unions as well as some retailers, grocery stores, and post offices. Domestic money orders can’t exceed $1,000, so they aren’t suitable for large transactions. However, while there is a limit on the amount of each money order, you can purchase multiple money orders to pay for more than one expense.
Money orders also have relatively low fees. For example, the United States Postal Service (USPS) charges $2.35 for money orders of $0.01 to $500.00, and $3.40 for money orders between $500.01 and $1,000.00
Which payment method is safer: cashier’s check vs. money order?
Cashier’s checks and money orders are both relatively safe forms of payment — both ensure the payment will not bounce.
However, cashier’s checks are generally safer due to the process financial institutions follow. Cashier’s checks are backed by a bank’s own funds, not your personal account, and are signed by a bank employee — making them harder to counterfeit and more trusted by recipients. The payee must also provide a photo ID when cashing the check, so only the person the financial institution specifies can access the money.
Money orders are paid from your personal bank account funds. They can be easier to forge, especially the ones purchased at retail outlets rather than banks.
That said, both are safer than personal checks or mailing cash, and both can be tracked if lost. But for high-value purchases, a cashier’s check is the more secure option.
An investment advisor (sometimes spelled “investment adviser”) is defined as a company or person who has a government registration allowing them to choose, manage and recommend investments for clients. Investment advisors are also sometimes referred to as stock brokers. They are not fiduciaries.
Unlike other financial advisors who may not be regulated, investment advisors are regulated by their state or the Securities Exchange Commission depending on how much money they manage. Investment advisors may also offer services like retirement planning.
COMMENTS APPRECIATED
The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.
I want to invest with a manager that has the skills to “hedge” a portfolio, but I do not wish to mix my money with other investors as in a hedge fund.
QUESTION:Can I hire hedge fund managers to manage my account separately?
Some hedge fund managers do take the time to recruit and manage separate accounts, with or without the help of referring brokers.
However, before long the administrative burden of managing so many separate accounts can become quite significant. Hence, the minimums for such separate accounts are generally much higher than if one were to invest in the manager’s hedge fund.
The best feature of these separate accounts is that potentially every aspect of the investment account, including fees, is negotiable. Other features include greater transparency and increased liquidity, since separately managed accounts can often be shut down on short notice.
Investors must be aware, however, that for practical purposes the portfolio manager generally will buy and sell the same securities in the separately managed accounts that the portfolio manager buys and sells in the hedge fund, yet the expenses incurred by the investor will likely be higher.
According to Baumol’s Cost Disease, in theory, workers should get higher pay because they get more productive. But an economist named William J. Baumol PhD noticed this isn’t always true; as in a paradox.
For example, musicians take the same time to play a string quartet as they did in Mozart’s day, but are paid more nevertheless. The reason is competition for labor; musicians can take other jobs. So rising wages in productive parts of the economy (eg, manufacturing) lead to higher wages in less productive sectors.
MORE: For more on the paradoxical disease, read this article; and for more on Baumol, read this one.
Free-market economists are those who believe that the market is better at allocating resources than governments and that excessive regulation and high public spending tend to diminish growth in the long run.
“Medical economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, insurance, mathematics and statistics, public health, provider recruitment and retention, Medicare, health policy, forecasting, aging and long-term care, are all commingled arenas …. The Dictionary of Health Economics and Finance will be an essential tool for doctors, nurses and clinicians, benefits managers, executives and health care administrators, as well as graduate students and patients. With more than 5,000 definitions, 3,000 abbreviations and acronyms, and a 2,000 item oeuvre of resources, readings, and nomenclature derivatives, it covers the financial and economics language of every health care industry sector.”
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on May 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINED
By Staff Reporters
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Stocks ticked down yesterday, ending a six-day rally after some influential CEOs—including JPMorgan Chase’s Jamie Dimon—warned that markets have grown too complacent about tariffs and potential stagflation. But it was a spectacular day for Warby Parker, which climbed more than 15% after Google announced it’s partnering with the eyewear company on Google Glass (RIP) a new smart glasses device.
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Stagflation is the simultaneous appearance in an economy of slow growth, high unemployment, and rising prices.
Once thought by economists to be impossible, stagflation has occurred repeatedly in the developed world since the 1970s.
Policy solutions for slow growth tend to worsen inflation, and vice versa. That makes stagflation hard to fight.
Stagflation is the combination of high inflation, stagnant economic growth, and elevated unemployment.
The term stagflation, a blend of “stagnation” and “inflation,” was popularized by British politician Lain MacLeod in the 1960s, during a period of economic distress in the United Kingdom. It gained broader recognition in the 1970s after a series of global economic shocks, particularly the 1973 oil crisis, which disrupted supply chains and led to rising prices and slowing growth. Stagflation challenges traditional economic theories, which suggest that inflation and unemployment are inversely related, as depicted by the Phillips Curve.
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According to Wikipedia, stagflation presents a policy dilemma, as measures to curb inflation—such as tightening monetary policy—can exacerbate unemployment, while policies aimed at reducing unemployment may fuel inflation.
In economic theory, there are two main explanations for stagflation: supply shocks, such as a sharp increase in oil prices, and misguided government policies that hinder industrial output while expanding the money supply too rapidly.
NOTE: A portmanteau word or part of a word made by combining the spellings and meanings of two or more other words or word parts (such as smog from smoke and fog).
The stagflation of the 1970s led to a re-evaluation of Keynesian economic policies and contributed to the rise of alternative economic theories, including monetarism and supply-side economics.
Posted on May 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Coinbase under investigation – Hit with ransom attack
Coinbase’s wild week got much wilder when the New York Times reported that the SEC has been looking into whether the crypto exchange misstated the size of its user base in securities filings. Per the New York Times, the investigation started under President Biden and has continued under President Trump.
The subject of the investigation appears to be Coinbase’s claim in past disclosures and marketing materials that it has 100 million “verified users.” A company spokesperson said it no longer reports that metric and the investigation should not continue.
The report came days after Coinbase joined the S&P 500, and just hours after it said it could lose $400 million following a recent hack by “rogue overseas” agents looking to steal customer data.
Financial Advisors and Financial Planners Usually Aren’t Millionaires
According to the most recent data from the Bureau of Labor Statistics (BLS), financial advisors had a median annual salary of $99,580 in 2023, which is significantly higher than the national average of $65,470. Of course, salaries of financial advisors can differ significantly by their location and level of expertise. The client’s profile may also have an impact on their compensation. But, many are not rich.
This is unfortunate. Financial advisors and Financial planners don’t rank among the millionaire professions in Thomas J. Stanley and William D. Danko’s book The Millionaire Next Door. Many work as salaried employees rather than entrepreneurs, lacking the scalable income potential of business owners who reinvest profits.
Stanley and Danko also stressed frugality, a challenge for advisors pressured to flaunt success—think luxury cars or upscale offices—making them “income-statement affluent” rather than “balance-sheet affluent.”
The truth is that a Financial Advisors’ success isn’t measured in client returns. Instead it is measured in their ability to gather assets and retain clients. In other words; Financial Advisors do not need to be good with money.
Financial Advisors need to be good with marketing, advertising, sales and people.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on May 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS [12:09 am, EST]
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Stock Futures are contracts to buy or sell a specific underlying asset at a future date. The underlying asset can be a commodity, a security, or other financial instrument. Futures trading requires the buyer to purchase or the seller to sell the underlying asset at the set price, whatever the market price, at the expiration date.
Stock futures pointed lower on Monday morning as investors weighed fresh warnings on U.S. debt and the potential for President Donald Trump’s trade war to heat up again.
Dow Futures: 42,406.00
Fair Value: 42,752.14
Change: – 330.000.77%
Implied Open: – 346.14
Late Friday night, Moody’s downgraded the U.S. credit rating one notch. This came as Congress tries to extend Trump’s tax cuts and add new ones, which are expected to deepen federal deficits.
S&P 500 surges 20% in Six Weeks as Stock Market Euphoria Returns to Wall Street
U.S. stock markets surged after an agreement between the Trump administration and China to lower tariffs.
The Dow Jones Industrial Average rose over 1,000 points, while the NASDAQ and S&P 500 gained nearly 600 and about 100 points, respectively last week. The improvement has erased recent losses from President Donald Trump’s tariffs.
The U.S. and China agreed to reduce tariffs on each other’s goods for an initial 90 days. The U.S. will lower tariffs on Chinese products from 145% to 30%, while China will cut its tariffs on American imports from 125% to 10%.
This unexpected breakthrough has eased tensions in their trade war and positively impacted global markets.
A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.
My medical practice has a small self-directed pension plan with profit sharing features.
QUESTION: Can my medical practice’s retirement plan invest in a hedge fund?
Such a pension fund falls under a category called self-directed “plan” assets.
Among the rules are that each participant in the plan counts toward the 100 investor maximum under which most hedge funds operate, that each plan participant be a fully accredited investor, and that the hedge fund keep investments such as pension plans and other funds covered under ERISA to less than 25 percent of total assets under management.
Markets started the day down yesterday but regained lost ground throughout the afternoon as investors decided that any day with no new tariff announcements is a good day.
Be advised: Fed Chair Jerome Powell warned that “supply shocks” pose a challenge for the economy, and that interest rates may need to remain higher for longer. Meanwhile, JPMorgan Chase CEO Jamie Dimon said a recession is still on the table.
Oil took a tumble on comments by President Trump that the US is nearing a deal with Iran over its nuclear program that could lift sanctions against the country.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on May 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Rick Kahler MSFP CFP™
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If I had a dollar for every time someone referred to the “good old days,” of the American economy, I could probably buy a vintage diner, jukebox and all, and still have enough left for a slice of apple pie.
The newest round of on-again, off-again tariffs is built around that same kind of nostalgia. Slapping big taxes on goods from other countries will supposedly protect American jobs and industries. The aim is to bring factories back, boost wages, and make the country more self-reliant.
This is a powerful story that taps into a deep feeling that we’ve lost control. Supporters argue that the U.S. has opened its markets and played by the rules, allowing many other countries to prosper at its expense, while America has been in a long, slow economic decline. This story frames the U.S. as a victim, with tariffs a form of payback to punish countries that have “taken advantage of us.”
Except that story is a myth. Rather than punishing foreign economies, the pain of tariffs hits Americans at home. Our businesses face costlier goods, consumers pay higher prices at the store, and the ripple effects include falling sales, layoffs, and frayed trade relationships.
In addition, the U.S. economy has actually been booming. Over the past three decades, the U.S. has pulled far ahead of most developed nations. In 2008, the American economy was about the same size as the Eurozone’s. Today, it’s nearly twice as large. Wages have risen. Even the poorest U.S. state now has a higher per-person income than countries like France, Japan, or the U.K.
So why do so many people still feel like we’re falling behind?
First, the growth hasn’t reached everyone, especially in rural America. In some areas and industries, jobs have disappeared and opportunities have dwindled.
Second, many people who are doing okay themselves have bought into a powerful, repeated myth that things are going terribly for everyone else.
This narrative takes hold in people’s internal voices, the parts of themselves shaped by past pain, fear, or frustration. Tariffs, then, can feel like a way to stand up and take action. It makes perfect sense to want to relieve anxiety by shutting the world out and protecting what is left.
Yet, when we act from fear or anger without pausing to reflect, we tend to overcorrect or trade one set of problems for another. This is what many economists and business leaders see happening with tariffs. Even supporters of tariffs are beginning to admit they’re a gamble. Many are still willing to take that gamble if it means restoring something they feel they’ve lost, a sense of purpose, security, and control.
Reacting out of fear in this way is not likely to create lasting solutions. A more challenging but more productive approach would be to take time to listen with compassion to those inner voices, helping them move past anxiety to find answers based in truth rather than myth. Maybe real liberation comes from letting go of narratives that no longer serve us, choosing a future built on connection, courage, and clarity.
Because if we keep heading down an isolationist path, turning inward out of fear, the future might not be the golden age we imagine. It might look a lot more like the actual 1950s, before the civil rights movement, before women fully entered the workforce, before the innovations that made the U.S. economy a global leader. A time more isolated, less equal, and far less dynamic than the one we’ve come to idealize.
That’s a version of the past we don’t need to relive, no matter what nostalgic song is playing on the jukebox.
Posted on May 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
BREAKING NEWS
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UnitedHealth Group just announced the exit of CEO Andrew Witty and suspended its 2025 forecast due to surging medical costs, sending its shares down more than 10%. Chairman Stephen Hemsley will become CEO, effective immediately.
The fourth-largest U.S company big revenue in 2024, Minnetonka-based UnitedHealth has experienced a turbulent year that saw the shock killing of United Healthcare CEO Brian Thompson in New York City, and a cyberattack that affecting an estimated 190 million people and cost the company an estimated $3.1 billion dollars.
Virtual chronic care provider Omada Health has filed to go public in the United States, the latest in a string of healthcare listings expected this year. Omada did not disclose the details as to how much it plans to raise from its IPO.
The San Francisco, California-based company, which last raised $192 million in a Series E funding round in 2022, reported a 38% increase in revenue to $169.8 million for 2024, according to its IPO paperwork. For the first quarter of 2025, the company posted a 56.6% year-on-year jump in revenue to $55 million. Omada has applied to list its common stock on the NASDAQ under the symbol “OMDA”.
Healthcare IPOs on U.S. exchanges have fetched $7.1 billion in 2024, compared with $2.8 billion a year earlier, according to data compiled by LSEG.
The Dow Jones exploded 1,000 points in pre-market trading, and the rally never waned toay. Both the Dow and the S&P 500 are nearly back to even for the year, while the NASDAQ clawed its way out of bear market territory.
Bonds tumbled while yields soared as the market pushed the timing for the Fed to cut interest rates back from July to September.
Gold sank as traders passed right on by the go-to investment for safety and sprinted straight toward equities.
Crude oil popped on the hopes of stronger economic growth for both the US and China now that the two countries are finally engaging in trade discussions.
Posted on May 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS
By Staff Reporters
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Markets: After stomach-churning ups and downs this spring, the stock market calmed down last week with all three major indexes holding steady and closing just a bit lower. This week, investors will be glued to the details of the trade agreement with China, an inflation report, and more earnings.
Breaking News Overnight: After talks in Switzerland this weekend, the US and China agreed to a large reduction in tariffs on each other. The US is lowering its tariffs on China from 145% to 30%, while China is lowering its tariffs on the US from 125% to 10%. The new tariff rates will be in effect for 90 days while the two sides continue talking.
Posted on May 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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I’ve received emails from readers asking my thoughts on DeepSeek. I need to start with two warnings. First, the usual one: I’m a generalist value investor, not a technology specialist (last week I was analyzing a bank and an oil company), so my knowledge of AI models is superficial. Second, and more unusually, we don’t have all the facts yet.
But this story could represent a major step change in both AI and geopolitics.
Here’s what we know:
DeepSeek—a year-old startup in China that spun out of a hedge fund—has built a fully functioning large language model (LLM) that performs on par with the latest AI models. This part of the story has been verified by the industry: DeepSeek has been tested and compared to other top LLMs. I’ve personally been playing with DeepSeek over the last few days, and the results it spit out were very similar to those produced by ChatGPT and Perplexity—only faster.
This alone is impressive, especially considering that just six months ago, Eric Schmidt (former Google CEO, and certainly no generalist) suggested China was two to three years behind the U.S. in AI.
But here’s the truly shocking—and unverified—part: DeepSeek claims they trained their model for only $5.6 million, while U.S. counterparts have reportedly spent hundreds of millions or even billions of dollars. That’s 20 to 200 times less.
The implications, if true, are stunning. Despite the U.S. government’s export controls on AI chips to China, DeepSeek allegedly trained its LLM on older-generation chips, using a small fraction of the computing power and electricity that its Western competitors have. While everyone assumed that AI’s future lay in faster, better chips—where the only real choice is Nvidia or Nvidia—this previously unknown company has achieved near parity with its American counterparts swimming in cash and datacenters full of the latest Nvidia chips. DeepSeek (allegedly) had huge compute constraints and thus had to use different logic, becoming more efficient with subpar hardware to achieve a similar result.
In other words, this scrappy startup, in its quest to create a better AI “brain,” used brains where everyone else was focusing on brawn—it literally taught AI how to reason.
Posted on May 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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I am back from what has become over the past two decades an annual pilgrimage to Omaha.
What’s fascinating about this trip is that it has everything and nothing to do with Warren Buffett. The main event that draws everyone to Omaha – the Berkshire Hathaway (BRK) annual meeting – is actually the least important part. I could have watched the shareholder meeting livestreamed on YouTube from the comfort of my living room couch.
The emergence of the Berkshire phenomenon reminds me of China’s manufacturing evolution. China initially attracted capital because of its cheap labor. But over time, China took this capital and plowed it into infrastructure. Factories were built next to each other, each specializing in certain areas. A specialized ecosystem emerged.
Today, Chinese labor is no longer cheap. It’s been replaced by automation, and now China is a powerhouse for manufacturing anything and everything.
The transformation that the BRK weekend has undergone followed a similar progression. Initially, the only way to absorb Buffett and Munger’s wisdom was to come to Omaha, as the event was not streamed. But then something interesting happened. The BRK weekend attracted people who shared the same value system, and friendships were formed. A variety of smaller events began to be scheduled throughout the same weekend across Omaha, and an equally specialized ecosystem emerged.
The shareholder meeting began to be streamed about ten years ago, but that has had no impact on attendance. This is one reason why I think Buffett is at peace with the idea of no longer presiding at the meeting – people will still come to Omaha the weekend before Mother’s Day. The BRK weekend now features dozens of excellent events.
I spoke at several, including an investing panel at Creighton University, alongside the wonderful Bob Robotti, a die-hard value investor who runs Robotti & Co. I’ve known Bob for years – at 72, he exhibits the same enthusiasm for stocks as someone decades younger – and this panel was an excellent example of what the BRK Omaha ecosystem has produced.
Bob and I have very different approaches to value investing. He loves cyclical businesses, while I generally shun them. Bob mentioned that he’d buy a very cheap business run by a mediocre manager, while I would not touch it with a ten-foot pole.
There is absolutely nothing wrong with either approach; indeed, there is an important lesson in it. Your investment philosophy and process have to fit your personality and your EQ. In my case, I get nervous (and thus irrational) when I own companies run by imbeciles who don’t have either skin or soul in the game. But the great thing about the BRK weekend is that I learn from Bob every time I spend time with him. He’s a thoughtful and genuinely kind human being.
From the outside, the BRK weekend may seem like a place where people simply want to learn how to get and stay rich. But this gathering transcends value investing and capitalism and genuinely celebrates human values. People (like me) bring their kids to this event. And just like at the main event, at the Q&A breakfast I hosted for my readers, many questions centered on life rather than investing.
My first Omaha reader meetup fit around a small restaurant table. This year, to my surprise, 450 people packed into a venue with standing-room only. I answered questions on every imaginable topic for just over two hours, and by the end I was exhausted.
This gave me even greater admiration for Buffett, who is four decades my senior, yet still fielded questions for four solid hours. I was delighted to hear Warren give a similar answer to one I had given the day before when asked what advice he’d give to graduating students: “Don’t worry too much about starting salaries and be very careful who you work for because you will take on the habits of the people around you.”
(Incidentally, we are going to host our next Q&A Breakfast on May 1, 2026. You can sign up for it here. It’s free, but I suggest you sign up early, as it fills up fast.)
I also participated (as I have for over a decade) in an investing panel at YPO (Young President Organization) in the beautiful Holland Performance Art Center with Tom Gaynor, CEO of Markel (often described as a baby Berkshire Hathaway) and Lawrence Cunningham. Lawrence authored perhaps the most important book about Buffett, The Essays of Warren Buffett, masterfully editing Warren’s annual letters into a cohesive volume. This year’s panel was one of those occasions where I found myself listening intently to my fellow panelists instead of speaking more.
Lawrence has met Greg Abel – Buffett’s designated successor – and feels optimistic about him. He’s probably right – this was one of Buffett’s most crucial decisions, which he did not make lightly. Yet I can’t imagine sitting for four hours listening to Greg Abel. I am sure he is a brilliant CEO, but he’s neither Buffett nor Munger – few individuals possess so much worldly wisdom and communicate it with such clarity and humor.
This brings me to the point of this note: the dramatic (yet not unexpected) announcement that Buffett is stepping down as CEO of BRK at the end of the year.
Before I comment on this, let me tell you a story. Imagine you have been watching a soap opera for 17 years. You arrive dutifully every year to watch every episode in person. And then you miss the last five minutes of the explosive finale before it goes off the air. This is what happened to me when Buffett announced his retirement as CEO.
A few minutes before noon, while Buffett was answering a question I’d heard before and appeared to be winding down, I suggested we slip out early for lunch to avoid the crowds. When we came back, I discovered that the meeting had gone on until 1 pm, and just before it ended, Buffett announced that he would step down at the end of the year. Seventeen years of watching Warren speak and I missed the most dramatic moment of all, followed by a five-minute standing ovation.
I think Buffett has engineered his exit brilliantly. He will still remain chairman, and even before the announcement he was not managing BRK’s day-to-day operations. As a collection of hundreds of companies that often have absolutely nothing in common with each other, BRK is already highly decentralized. Buffett’s main contribution has been capital allocation.
Giving up the CEO title while he’s still alive means Buffett has brought in his replacement in an orderly way and created a smooth transition. But I have a feeling that on January 1, 2026, when Greg Abel officially becomes CEO, nothing will really change, and Warren will continue doing what he’s been doing for as long as he can. If Buffett is able – he’ll be 95 – he’ll still drive to the office and stop by McDonald’s for a breakfast sandwich (there’s a lot of wisdom in finding pleasure in little things). His son Howard Buffett will become chairman after Warren, with his only job being to preserve the culture. I’ve been asked what I think of BRK stock. We bought the stock during the pandemic. It has done better than I expected, in part because of the strong performance of Apple, which was BRK’s largest holding. But BRK today is an unexciting investment at its current price. In all honesty, it is a conglomerate with some good and some merely okay businesses.
As a consumer, I get a (small) glimpse into how BRK businesses are being run by visiting Dairy Queen. BRK owns DQ, and I love their soft-serve ice cream (though I only eat it when I travel). My favorite part of research!
DQ has (or maybe had) a strong brand and operates on a capital-light model as a franchisor. But most stores I have visited looked like they have been neglected and need fresh paint. To be sure, I understand the limitations of this “analysis,” and DQ overall amounts to a rounding error on BRK’s financials. But little things often reveal much about big things.
BRK’s big businesses, from what I can glean through their financials, are not particularly well managed – GEICO and BNSF (railroad) have definitely been undermanaged lately. BNSF is not nearly as efficient as its competitors that embraced precision railroading, and until recently GEICO was losing market share to Progressive.
BRK’s reinsurance business, a significant source of BRK’s profitability, is run by the extraordinary Ajit Jain. Ajit is in his 70s and unfortunately it seems he is not in great health. Is his replacement going to shoot the lights out, like he did? We don’t know. But Ajit is probably more important to BRK today than Buffett.
BRK is not going to melt into oblivion after Buffett is gone, but its best days are behind it. As Buffett has acknowledged, just its size alone makes it very difficult for BRK to grow. Truth be told, even if Buffett were thirty years younger and continued to run BRK, I am not sure the results would be much different than what I think the future holds with Abel at the helm.
Buffett and Charlie Munger had a tremendous impact on me as an investor and human being. I am incredibly thankful to both. I hope Warren is there next year, but, in either case, I will be.
Posted on May 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The DOJ wants Google to break up its advertising empire
Following a federal court’s ruling that Google operates an illegal ad-tech monopoly, the Justice Department requested that the company be forced to sell two major products—its Ad Exchange and a management platform—as an appropriate remedy.
Google, unsurprisingly, asked the judge for a less drastic remedy that would see the company make certain changes to its practices without having to break up its ad business. The judge won’t rule until the remedies trial starts in September.
Until then, Google has another thing to dread:
The government also wants the tech giant to sell Chrome to remedy its other monopoly (in search).
The phrase “sell in May and go away” suggests that investors should sell their stocks in May and avoid the market during the summer months, as historical data indicates poorer stock performance during this period.
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It’s Friday morning, so you’re probably clocking out once you’re done reading this ME-P. And who could blame you, after such a wild month of watching your portfolio zig & zag with every headline.
In fact, why not just sell all your stocks and walk away entirely? You’ve got to admit, it’s tempting. After all, markets have completed an incredible round trip since Liberation Day—you could just call it even, start celebrating Cinco de Mayo a bit late, and maybe check your portfolio again sometime around August.
“Sell in May and go away” might sound like appealing advice these days, especially considering that the market usually spends the next six months under-performing: The S&P 500 gains just 1.8% on average from May through October, the worst-performing stretch of the year historically.
These ‘worst six months’ have gained in eight of the last 10 years,” he recently wrote. He continued: “Not to mention the month of May has been higher nine of the past 10 years, so maybe we should call it,
Posted on May 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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Today, we’re diving into two thought-provoking questions:
What’s a famous investment rule I don’t agree with? Which key characteristics should a good investor have? Again:
What’s a famous investment rule I don’t agree with?
Which key characteristics should a good investor have?
A Famous Investment Rule I Don’t Agree With: “Buy and Hold”
Buy and hold becomes a religion during bull markets. Then, holding a stock because you bought it is often rewarded through higher and higher valuations. There’s a Pavlovian bull market reinforcement – every time you don’t sell (hold) a stock, it goes higher.
Buying is a decision. So is holding, but it should not be a religion but a decision. The value of any company is the present value of its cash flows. When the present value of cash flows (per share) is less than the price of the stock, the stock should not be “held” but sold.
WarrenBuffett is looked upon as the deity of buy and hold.
Look at Coca Cola when it hit $40 in 1999. Its earnings power at the time was about $0.80. It was trading at 50 times earnings. It was significantly overvalued, considering that most of the growth for this company was in the past.
Fast-forward almost a quarter of a century – literally a generation. Today the stock is at $60. It took more than a decade to reclaim its 1999 high. Today, Coke’s earnings power is around $1.50–1.90. Earnings have stagnated for over a decade. If you did not sell the stock in 1999, you collected some dividends, not a lot but some. The stock is still trading at 30–40x earnings. Unless they discover that Coke cures diabetes (not causes it), its earnings will not move much. It’s a mature business with significant health headwinds against it.
“Long-term” and “buy-and-hold” investing are often confused.
People should not own stocks unless they have a long-term time horizon. Long-term investing is an attitude, an analytical approach. When you build a discounted cash flow model, you are looking decades ahead. However, this doesn’t mean that you should stop analyzing the company’s valuation and fundamentals after you buy the stock, as they may change and affect your expected return. After you put in a lot of analytical work and buy the stock, you should not simply switch off your brain and become a mindless buy-and-hold investor.
This doesn’t mean you shouldn’t be patient, but holding, not selling, a stock is a decision.
Posted on May 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Rick Kahler CFP™ MSFP
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DECLINE OF THE DOLLAR
On-again, off-again tariffs. Rising prices. Dramatic market swings. The anxiety-producing headlines come so fast it’s hard to know what to worry about first. Meanwhile, one serious consequence of all this chaos is going almost unnoticed. That is the decline of the dollar.
Since the start of this year, the value of the U.S. dollar has slipped more than 10% against other major currencies. That drop is not just an economic statistic. It affects all Americans’ daily lives.
People are feeling the pinch of rising prices at checkout lines, gas stations, and shipping counters. But there isn’t a full understanding of why. Tariffs are only half the story. The weakening dollar amplifies those price increases even further.
For years, the dollar remained strong even as the national debt ballooned. It benefited from its reputation as a safe haven, from global demand, and from U.S. interest rates. But much of that strength, as we now see, was fragile—propped up more by perception than fundamentals. In April, sweeping tariffs triggered a sharp market correction, and the dollar suddenly fell to its lowest point in over three years. Market confidence vanished overnight.
This was more than a market reaction. It signaled a collapse in trust—not just in policy, but in principle. It is no longer a given that the U.S. will act with consistency, reason, and long-term responsibility. What’s unraveling is both our country’s financial credibility and the moral foundation that underpinned it.
When a currency represents a nation, its value reflects more than economics. It reflects governance, accountability, stability, and integrity. When the dollar stumbles, it speaks to who we are, and whether we can still be counted on.
Yet, most people aren’t talking about the decline of the dollar. This may come from being overwhelmed, choosing to ignore even more bad news, or actually believing that this is a necessary step in making things better. It is not.
We all respond differently to financial uncertainty. Some lean into hyper-vigilance—tightening budgets, tracking every headline. Others shut down, turning toward distraction. Still others press on as if nothing has changed. These are all natural human reactions.
They are not the same as leadership. And leadership—internal and external—is what’s needed now. Not panic. Not blame. Just the courage to face where we are and the willingness to start again from there.
But leadership is in short supply in Washington, where many in both parties remain silent. Some fear political retribution from the administration, others fear backlash from increasingly extreme and vocal constituencies. That silence costs us all.
A respected government official recently told me that, while some of the domestic damage to our economy could be repaired within a few years, rebuilding global confidence in the United States may take a generation. That is a reflection of the rapid erosion of trust that has already happened in the last three months. Trust that took decades to build has been unwound in a matter of weeks. Even if we reversed every policy decision tomorrow, the damage is done.
We cannot change what’s already happened. We can still choose to show up. To pay attention. To have the hard conversations. To lead our own financial lives with more clarity, integrity, and intention than before. That kind of personal leadership may not fix the dollar. But it can help rebuild what underlies its value: trust, steadiness, and the moral grounding we’ve begun to lose.
Because the dollar’s decline is more than an economic headline.
It’s a story about who we are—and whether we’re ready to live with open eyes in a world where the old assumptions no longer hold.
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