BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
[Click on Image to Enlarge]
ME-P Free Advertising Consultation
The “Medical Executive-Post” is about connecting doctors, health care executives and modern consulting advisors. It’s about free-enterprise, business, practice, policy, personal financial planning and wealth building capitalism. We have an attitude that’s independent, outspoken, intelligent and so Next-Gen; often edgy, usually controversial. And, our consultants “got fly”, just like U. Read it! Write it! Post it! “Medical Executive-Post”. Call or email us for your FREE advertising and sales consultation TODAY [770.448.0769]
Medical & Surgical e-Consent Forms
ePodiatryConsentForms.com
iMBA Inc., OFFICES
Suite #5901 Wilbanks Drive, Norcross, Georgia, 30092 USA [1.770.448.0769]. Our location is real and we are now virtually enabled to assist new long distance clients and out-of-town colleagues.
ME-P Publishing
SEEKING INDUSTRY INFO PARTNERS?
If you want the opportunity to work with leading health care industry insiders, innovators and watchers, the “ME-P” may be right for you? We are unbiased and operate at the nexus of theoretical and applied R&D. Collaborate with us and you’ll put your brand in front of a smart & tightly focused demographic; one at the forefront of our emerging healthcare free marketplace of informed and professional “movers and shakers.” Our Ad Rate Card is available upon request [770-448-0769].
Turkey’s lira plunged 7% to a record low yesterday in its biggest selloff since a historic 2021 crash, a move traders said is a “strong signal” that Ankara is moving away from state controls toward a freely traded currency. The currency has come under increasing pressure since President Tayyip Erdogan was re-elected on May 28. It was trading at 23.18 against the dollar at 1500 GMT, after touching a record low of 23.19, bringing its losses this year to around 20%.
***
Treasury Secretary Janet Yellen, in her first interview since the U.S. debt-ceiling was lifted last week by Congress, warned on Wednesday about the potential for banks to feel strain from their exposure to weakening commercial real estate valuations. Yellen was asked by CNBC “Squawk Box” host Andrew Ross Sorkin about if she’s worried about the state of estimated $20.7 trillion commercial real-estate market, particularly the office, and if weakness in the sector could potentially spark more bank failures.
“Well, I do think that there will be issues with respect to commercial real estate,” Yellen said. “Certainly, the demand for office space since we’ve seen such a big change in attitudes and behavior toward remote work has changed and especially in an environment of higher interest rates.”
***
The equities market diverged today between a small handful of strong-performing mega-cap companies, which delivered most of the gains recently in the big benchmark indexes, and the lagging majority. Such concentration suggests a weakness below the headline numbers that could become a problem down the line.
Here is where the major benchmarks ended today:
The S&P 500® Index (SPX) was down 16.33 points (0.4%) at 4267.52; the Dow Jones Industrial Average (DJIA) was up 91.74 (0.3%) at 33,665.02; the NASDAQ Composite (COMPX) was down 171.52 (1.3%) at 13,104.90.
The 10-year Treasury note yield (TNX) was up about 9 basis points at 3.791%.
CBOEs Volatility Index (VIX) was down 0.04 at 13.92.
Smaller financial companies were also in the spotlight again, with the KBW Regional Banking Index (KRX) continuing its rebound with a nearly 4% jump. Energy stocks were also strong as crude oil futures climbed more than 1%, and transportation companies also gained. Communication Services led decliners among S&P 500 sectors.
The Normandy landings were the landing operations and associated airborne operations on Tuesday, 6th June 1944 of the Allied invasion of Normandy in Operation Overlord during World War II. Code-named Operation Neptune and often referred to as D-Day, it was the largest seaborne invasion in history.
***
It has also been 42 years since the CDC first reported on AIDS in the US, describing five Los Angeles-area patients with Pneumocystis jiroveci pneumonia. Today about 1.2 million people in the US live with HIV, the virus that causes AIDS, a condition that’s considered chronic but not necessarily fatal. Still, US leaders want to end the HIV epidemic by 2030.
Advocates are calling for gun violence to be considered as an “adverse childhood experience.”
Chicago health officials still recommend exercising caution over Mpox in the year following a major outbreak.
***
With the drama of earnings season, the debt ceiling battle, and last Friday’s crucial jobs report in the rear-view mirror, Wall Street enters the week seeking new catalysts.
The S&P 500 Index (SPX) starts the week on the cusp of a new bull market. A close of 4,292 or above would represent approximately a 20% gain from the 2022 low close of 3,577 posted last October 12. A 20% gain from the bottom represents a new bull market. That said, the SPX is still down about 11% from its all-time high close of 4,796 posted January 3, 2022.
You may recall a strong rally last summer. But the 17% rally that lasted from mid-June 2022 through mid-August 2022 lifted the SPX just 17%—not enough to put it into bull market territory.
The 10-year Treasury note yield ($TNX) was down slightly to 3.68%. The U.S. Dollar Index ($DXY) is up slightly to 104.29. The Cboe Volatility Index® ($VIX) has been in positive territory all day today and was last seen up by 0.27 to 14.87. WTI Crude Oil (/CL) is up to $73.22 per barrel after Saudi Arabia said it would cut production.
Gold prices have traded in a range of $1,953.80 to $1,978.00 and were last seen trading higher by 0.17% to $1,973.00.
Natural Gas prices have traded in a range of $2.184-2.2301 so far today and were last seen trading higher by $0.077 (or + 3.55%) to $2.249/MMBtu.
Mobile money, mobile money transfers and mobile wallets
By Staff Reporters
***
***
DEFINITION: A mobile payment, also referred to as mobile money, mobile money transfer and mobile wallet, is any of various payment processing services operated under financial regulations and performed from or via a mobile device, as the cardinal class of digital wallet. Instead of paying with cash, cheque, or credit cards, a consumer can use a payment app on a mobile device to pay for a wide range of services and digital or hard goods. Although the concept of using non-coin-based currency systems has a long history, it is only in the 21st century that the technology to support such systems has become widely available.
Mobile payments began adoption in Japan in the 2000s and later all over the world in different ways. The first patent exclusively defined “Mobile Payment System” was filed in 2000.
Don’t use Mobile Payment Services to Park Cash, CFPB Warns.
Venmo may not be that much better than stuffing bills under your mattress when it comes to keeping your money safe long term, the Consumer Financial Protection Bureau recently cautioned.
The app and others, like CashApp, Apple Pay, and PayPal, aren’t banks, so the Federal Deposit Insurance Corporation doesn’t provide insurance for funds stored there, the CFPB pointed out. The agency said there are billions of dollars at risk if these apps suffer an SVB-like bank failure.
The US kept adding jobs according to new data from the Bureau of Labor Statistics. The economy gained 339,000 pay-rolled employees in May, more than in each of the preceding three months and way more than the 190,000 Dow Jones predicted (to be fair, expert estimates low-balled 13 of the last 16 job reports, according to CNBC. This growth happened despite climbing interest rates, inflation, recent bank failures, and a nerve-racking debt ceiling standoff that threatened to destroy the economy And, Wall Street interpreted the data as a big green “buy” sign. For example:
Stocksleaped up last week as investors celebrated the deal to lift the debt ceiling being showed that the economy is still going strong. In fact, Lululemon stretched toward the heavens after beating earnings expectations thanks to a 24% year over year jump in sales.
But not all indications pointed to the hot streak continuing indefinitely.
The unemployment rate inched, wage growth slowed, and workers appear less self-assured in the labor market:
The self-employed lost 369,000 people from its ranks in May, a possible sign that folks might be ditching the self-employment for the security of a traditional employer.
And, recent data shows the quit rate has declined from an all-time high in late 2021, bringing an end to the pandemic job-hopping trend dubbed the Great Resignation.
Ultimately, the Fed will have to use the conflicting and mixed economic indicators to decide whether to further crank up interest rates at their next meeting. The Federal Reserve has been hinting that it might cease raising interest rates, and investors seem convinced the central bank will follow through and at least “skip” a hike this month even though the labor market is still radiating heat.
NOTE: The US debt-ceiling bill just passed, June 1, 2023. So, here are some budgeting rules for doctors and medical professionals.
***
Budgeting is probably one of the greatest tools in building wealth. However, it is also one of the greatest weaknesses among physicians who tend to live a certain lifestyle. This includes living in an exclusive neighborhood, driving an expensive car, wearing imported suits and a fine watch, all of which do not lend themselves to expense budgeting. Only one in ten medical professionals has a personal budget. Fear, or a lack of knowledge, is a major cause of procrastination.
The following guidelines will assist in this microeconomic endeavor:
Set reasonable goals and estimate annual income. Do not keep large amounts of cash at home, or in the office. Deposit it in a money market account for safety and interest.
Do not pay bills early, do not have more taxes withheld from your salary than you owe, and develop spending estimates and budget fixed expenses first. Fixed expenses are usually contractual, and may include housing, utilities, food, telephone, social security, medical, debt repayment, homeowner’ or renter’s insurance, auto, life and disability insurance, and maintenance, etc.
Make variable expenses a priority. Variable expenses are not usually contractual, and may include clothing, education, recreational, travel, vacation, gas, entertainment, gifts, furnishings, savings, investments, etc.
Trim variable expenses by 10-15 percent, and fixed expenses, when possible. Ultimately, all fixed expenses get paid and become variable in the long run.
Use carve-out or set-asides for big ticket items and differentiate “wants from needs.”
Know the difference between saving and investing. Savers tend to be risk adverse and investors understand risk and takes steps to mitigate it.
Determine shortfalls or excesses with the budget period.
Track actual expenses.
Calculate both income and expenses as a percentage of the total, and determine if there is a better way to allocate resources. Then, review the budget on a monthly basis to determine if there is a variance. Determine if the variance was avoidable, unavoidable, or a result of inaccurate assumptions, and take needed corrective action.
***
Verify Your Budget and Follow a Financial Plan
The process of establishing a budget relies heavily on guesswork, and the use of software or “apps”, that seamlessly track expenditures and help your budget and your financial plan become more of reality. Most doctors underestimate their true expenses, so lumping and best guesses on expense usually prove very inaccurate. Personal financial software and mobile phone applications make the verification of budgets easier. Once your personal accounts are setup, free apps like MINT.com will let give you a detailed report on where your money is going and the adjustments you must make. Few professions make larger contributions to the Internal Revenue Service than physicians and the medical profession. It is very important to categorize different budget categories not only to be proactive about your expenses, but also to accurately reflect the effect your different expenditures have on your real savings capability. All expense dollars are not equal.
For example, a mortgage payment, which is mostly interest expense in the early years, is likewise mostly tax deductible. Spending money on your family vacation is typically not tax deductible. Itemized deductions, which are deductions that a US taxpayer can claim on their tax return in order to reduce their Adjustable Gross Income (AGI), may include such costs as property taxes, vehicle registration fees, income taxes, mortgage expense, investment interest, charitable contributions, medical expenses (to the extent the expenses exceed 10% of the taxpayers AGI) and more.
Employing a qualifiedcertified medical planneR® that utilizes a cash-flow based financial planning software program may help the physician identify their actual after-tax projected cash flow and more accurately plan their future.
The Atlantic hurricane season is the period in a year, from June 1st through November 30th, when tropical or subtropical cyclones are most likely to form in the North Atlantic Ocean. These dates, adopted by convention, encompass the period in each year when most tropical cyclogenesis occurs in the basin. Even so, subtropical or tropical cyclogenesis is possible at any time of the year, and often does occur.
Interest Rates?
New US government data shows there were more open jobs last month than expected, raising the possibility that the Federal Reserve could keep hiking Interest Rates Up.
Banks
Shares of large and mid-sized U.S. banks sharply under performed the broader markets with worries about commercial real estate loans in focus among bank investors.
Companies
The e-commerce giant Amazon has agreed to shell out the cash to settle a pair of lawsuits lodged by the Federal Trade Commission. It will cough up $5.8 million to resolve claims that it let employees and contractors access footage from Ring doorbell cameras and another $25 million because Alexa allegedly improperly retained information from children. Amazon’s also facing criticism from its staff—hundreds of corporate employees walked out yesterday to protest the company’s layoffs, return to office mandate, and contributions to climate change.
Advance Auto Parts tanked after the car parts seller cut its dividend and outlook for the year.
The Markets
Here is where the major benchmarks ended, yesterday:
The S&P 500 Index was up 41.19 points (1.0%) at 4221.02; the Dow Jones industrial average (DJIA) was up 153.30 (0.5%) at 33,061.57; the NASDQ Composite was up 165.70 (1.3%) at 13,100.98.
The 10-year Treasurynoteyield (TNX) was down about 3 basis points at 3.603%.
CBOE’s Volatility Index (VIX) was down 2.25 at 15.69.
Oilfield services providers and other energy companies led sector gains, as crude oil futures rallied nearly 3% and pushed back above $70 barrel despite higher-than-expected U.S. inventories reported Thursday. Semiconductor makers and other tech companies continued their recent show of strength. The U.S. Dollar Index ($DXY) fell to its lowest level in more than a week amid ideas the Fed may soon “pause” its sharp rate hikes of the past year.
Student loan payments could restart soon. Tucked into the debt ceiling deal agreed to by President Biden and House Speaker Kevin McCarthy is a measure that requires student loan borrowers to start paying their monthly bills again 60 days after June 30th.
A freeze on repayments has been in place since March 2020 due to COVID-19, and it’s been extended several times as the pandemic dragged on. This deadline for the resumption of payments is similar to the timeline previously laid out by President Joe Biden, but it prevents him from issuing another pause.
According to ABC News, the US House of Representatives just approved a bill to raise the nation’s debt ceiling while cutting some government spending over the next two years, in a major victory for both the White House and Republican leaders as the country tip-toes closer to a historic default on its bills. The final vote was 314-117. Now, the deal moves to the Senate, where Majority Leader Chuck Schumer has promised to work to pass it quickly.
***
***
Here is where the major benchmarks ended yesterday:
The S&P 500 Index was down 25.69 points (0.6%) at 4179.83; the Dow Jones industrial average was down 134.51 (0.4%) at 32,908.27; the NASDAQ Composite was down 82.14 (0.6%) at 12,935.29.
The 10-year Treasury yield was down about 5 basis points at 3.641%.
CBOE’s Volatility Index was up 0.26 at 17.74.
Regional banks were among the weakest performers Wednesday, while energy stocks also slumped as crude oil futures extended a recent sell-off.
The utilities and healthcare sectors were among the few gainers.
Despite weakness in technology, the NASDAQ still ended with a gain of 5.8% for the month, while the S&P 500 was up 0.3%. The U.S. dollar index rose to a 2½-month high.
Workers appear to value paid time off even more than having employer-funded health insurance, a recent study found. The Pew Research Center report called “How Americans view their jobs” found 62% of the 5,900 people surveyed felt it’s “extremely” important to have paid time off for vacations or minor illness, with a further 27% saying it’s “very” important. That’s higher than the 51% who said employer-funded health insurance was extremely important, with 28% saying it’s very important.
And, here is where the major market benchmarks ended yesterday:
The S&P 500 Index was up 0.07 point at 4205.52; the Dow Jones industrial average was down 50.56 (0.2%) at 33,042.78; the NASDAQ Composite was up 41.74 (0.32%) at 13,017.43.
The 10-year Treasury yield was down about 13 basis points at 3.694%.
CBOE’s Volatility Index was little changed at 17.46.
Oilfield services companies and others in energy were among the weakest performers as crude oil futures dropped more than 4% to less than $70 a barrel, reflecting ample supply.
Consumer staples and health care were also weak. The U.S. dollar index was down slightly after rising earlier to its highest level since mid-March.
The value of the US tech company Nvidia has soared by a quarter after it predicted a boom in demand for its computer chips to meet the needs of artificial intelligence products such as ChatGPT. Nvidia’s share price rose by 25% in early trading on the back of the announcement, and gave it a market valuation of more than $940bn (£760bn) after stock markets opened on Wall Street on Thursday, up from $755bn on Wednesday evening. The share price had already more than doubled over the course of 2023, amid huge optimism over the rapid progress of generative AI products. These require massive data centers full of semiconductor chips to operate.
***
Here is where the major benchmarks ended yesterday:
The S&P 500® Index was up 36.04 points (0.9%) at 4151.28; the Dow Jones industrial average was down 35.27 (0.1%) at 32,764.65; the NASDAQ Composite was up 213.93 (1.7%) at 12,698.09.
The 10-year Treasury yield was up about 10 basis points at 3.823%.
CBOE’s Volatility Index was down 1.01 at 19.02.
The Philadelphia Semiconductor Index also rose more than 4% to near a 14-month high, while the NASDAQ-100 hit a 13-month high. Transportation stocks were also higher. Oilfield services companies were among the weakest performers as crude oil futures fell more than 3%.
***
US credit rating called into question
Credit rating agency Fitch just warned that the fight over the debt ceiling could force it to question the US’ perfect credit rating. It said it had put the nation’s triple-A credit rating on “rating watch negative,” meaning it’s poised for a downgrade if lawmakers can’t work things out. Even negotiations that drag on too long before a deal is reached could trigger a downgrade: That’s what happened in 2011, when S&P dinged the US’ credit over default fears. S&P still hasn’t returned the nation’s score to its highest rating.
Thousands of clients of Maxim Healthcare Services are about to receive a payment of up to $5,000 in compensation for a data breach. According to information obtained by The Sun, the private medical personnel company based in Columbia, Maryland; agreed to pay 2020 data breach claims filed in a class action lawsuit by residents of the state of California.
***
***
Gold futures tallied a third consecutive session decline settling at their lowest in nearly a week as further strength in the U.S. dollar pressured prices for the precious metal. Gold gave up early gains that had been driven by uncertainty surrounding a U.S. debt-ceiling deal in Congress.
***
And, here is where the major benchmarks ended yesterday:
The S&P 500 Index was down 30.34 points (0.7%) at 4115.24; the Dow Jones industrial average was down 255.59 (0.8%) at 32,799.92; the NASDAQ Composite was down 76.08 (0.6%) at 12,484.16.
The 10-year Treasury yield was up about 4 basis points at 3.742%.
CBOEs Volatility Index was up 1.52 at 20.04.
Technology and regional bank stocks were among the weakest sectors, with the Philadelphia Semiconductor Index down more than 2%. Energy was one of the few gainers among S&P 500 sectors as crude oil futures climbed to a three-week high of near $74 a barrel. The U.S. dollar index rose a third straight day to a two-month high.
Almost 2 decades ago, Fortune magazine carried the headline “When Six Figured Incomes Aren’t Enough. Now Doctors Want a Union.” To the man in the street, it was just a matter of the rich getting richer.
The sentiment was more precisely quantified, according to health economist and financial advisor Dr. David E. Marcinko MBACMP™, in the March 31, 2005 issue of Physician’sMoney Digest, who with Editor Gregory Kelly reported that a 47-year-old doctor with $184,000 in annual income would need about $5.5 million dollars for retirement at age 65.
Of course, physicians were not complaining back then under the traditional fee-for-service system; the imbroglio only began when managed care adversely impacted income, or when the stock market crashed in 2008; or with passage of the Patient Protection and Affordable Care Act [PP-ACA] in 2010 or its’ full implementation in 2014.
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Regional bank stocks slid again on Friday on fears that more banks might fail or need intervention from the government. The KBW Regional Bank index fell by nearly 3% from rumors that Treasury Secretary Janet Yellen said additional bank consolidations might need to occur, according to a CNN report.
***
Yesterday, stocks turn south after Republicans walked out on debt ceiling talks, but the S&P 500 and NASDAQ are still higher for the week. In summary:
The Dow Jones Industrial Average fell 109.28 points, or 0.3%, to close at 33,426.63.
The S&P 500 fell 6.1 points, or 0.1%, to finish at 4,191.98.
The NASDAQ Composite dropped 30.94 points, or 0.2%, to end at 12,657.90.
All three major indexes booked weekly gains, with the Dow rising 0.4% to snap two straight weeks of losses. The S&P 500 saw a 1.6% gain for the week, also snapping back-to-back weekly losses; the NASDAQ rose 3% in a fourth straight week of gains for its longest winning streak since the week ending Feb. 3rd, according to Dow Jones Market Data.
Markets: Stocks climbed for the second straight day as a last-minute deal to raise the debt ceiling begins to take shape. GOP House Speaker Kevin McCarthy and Democratic Senate Majority Leader Chuck Schumer signaled their chambers could vote next week on an agreement that would avert the US’ first-ever default.
Stock spotlight: Netflix shares popped after the streamer said its cheaper ad-supported plan is off to a hot start. Earlier this week, Netflix said that 25% of its new subscribers opted for the ad tier in regions where it’s available.
***
Here is where the major benchmarks ended yesterday:
The S&P 500 Index was up 39.28 points (0.9%) at 4198.05; the Dow Jones industrial average was up 115.14 (0.3%) at 33,535.91; the NASDAQ Composite was up 188.27 (1.5%) at 12,688.84.
The 10-year Treasury yield was up about 7 basis point at 3.65%.
CBOE’s Volatility Index was down 0.78 at 16.09.
The tech sector continued to be one of the market’s strongest performers, with the Philadelphia Semiconductor Index jumping nearly 3% and the Nasdaq-100 closing at a 13-month high. Real estate led decliners among S&P 500 sectors.
Also, the U.S. dollar index surged near a two-month high amid growing confidence the Fed won’t be lowering rates any time soon.
The following companies are in the earnings pipeline this week:
Home Depot is due to release its results for its last fiscal quarter before the market opens Tuesday. Analysts expect the home-improvement chain to report earnings of $3.81 per share, down from $4.09 during the same quarter a year earlier, according to Zacks Investment Research. Home improvement businesses benefited from increased spending on renovations during the pandemic but have struggled as inflation picked up. Home Depot’s shares were down about 0.9% Monday.
Target will follow Wednesday, with analysts predicting the big box retailer will report earnings of $1.75 per share, down from $2.19 the year before. Again, investors will be looking to see how Target has dealt with inflation and recession-wary shoppers. Its shares were up more than 1.3%.
Walmart wraps up big-retailer week Thursday. Analysts expect the retailer to report earnings of $1.31 per share, a slight improvement from $1.3 a year earlier. Its shares were down about 0.8%.
Cisco Systems (CSCO) will report results for the fiscal quarter ended in April on Wednesday. Analysts expect the software company to report earnings of $0.87 per share, up from $0.78 a year before.
Two major Chinese tech companies will also report results this week, with Baidu (BIDU) going first before market open Tuesday and Alibaba (BABA) following Thursday.
The executive branch of the European Union said Monday that Microsoft has offered enough remedies to address antitrust concerns, paving the way for the proposed $69 billion acquisition of gaming giant Activision Blizzard. The acquisition was opposed by rival game developer and PlayStation console maker Sony over fears it would see Microsoft’s Xbox platform push it out of the market. Market regulators globally, meanwhile, expressed concern over whether Microsoft would come to dominate the cloud-gaming market through the acquisition. On Monday, however, the European Commission, the executive arm of the EU, said Microsoft had done enough to allay concerns on cloud gaming specifically to warrant a positive decision on the merger.
***
Here is where the major benchmarks ended [yesterday] Monday:
The S&P 500 Index was up 12.20 points (0.30%) at 4,136.28; the Dow Jones Industrial Average was up 47.98 (0.14%) at 33,348.60; the NASDAQ Composite was up 80.47 (0.66%) at 12,365.21.
The 10-year Treasury yield was up 3 basis points at 3.50%.
CBOE’s Volatility Index was up 17 basis points at 17.20.
Financial companies were among the leaders Monday, with regional lenders Citizens Bank (CFG), PacWest Bancorp (PACW), Western Alliance (WAL), and Zions Bancorporation (ZION) all bouncing higher after a punishing stretch for the banks last week. The materials and technology sectors were also up, while utilities and real estate lagged.
Here is where the major benchmarks ended this week:
The S&P 500 Index was down 6.54 points (0.2%) at 4124.08; the Dow Jones industrial average was down 8.89 at 33,300.62; the NASDAQ Composite was down 43.76 (0.4%) at 12,284.74.
The 10-year Treasury yield was up about 7 basis points at 3.464%.
CBOE’s Volatility Index was up 0.10 at 17.03.
Consumer Discretionary Socks led the declines Friday among S&P 500 sectors, with financials and energy shares also weaker. Worries over the potential for more trouble in the banking sector helped send the KBW Regional Bank Index to its lowest close since late 2020. Utilities and Consumer Staples were among the stronger performers.
Jerome Powell May Get a New No. 2. President Biden said yesterday that he would nominate economist Philip Jefferson, who is already on the Fed’s board, to become second-in-command at the central bank, replacing Lael Brainard. He also plans to nominate the current US rep to the World Bank, Adriana Kugler, to an empty board seat. She would be the Fed’s first Latina governor. If confirmed by the Senate, the pair will jump into their new roles as the Fed continues to try to curb inflation without tipping the economy into a recession.
INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARYFROM iMBA, Inc.
An e-book is an electronic or digital book that can be read on a computer or a handheld device.
Our new e-books consists of text, images, and are fixed to a specific spot on the page.
And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.
You can then access the e-book and read it, or highlight pages and even take side notes.
e-Books Save Money
With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!
FINANCE: Delta is a risk sensitivity measure used in assessing derivatives. It is one of the many measures that are denoted by a Greek letter. The series of risk measures that use such letters are fittingly referred to as the Greeks. They are often also called risk measures, hedge parameters, or risk sensitivities.
ACCOUNTING: Delta is the ratio of the change in price of an option to the change in price of the underlying asset. Also called the hedge ratio; For a call option on a stock, a delta of 0.50 means that for every $1.00 that the stock goes up, the option price rises by $0.50.
INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARYFROM iMBA, Inc.
An e-book is an electronic or digital book that can be read on a computer or a handheld device.
Our new e-books consists of text, images, and are fixed to a specific spot on the page.
And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.
You can then access the e-book and read it, or highlight pages and even take side notes.
e-Books Save Money
With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!
Happy Cinco de Mayo. The holiday commemorates the defeat of French forces by the Mexican army at the Battle of Puebla in 1862, but its popularity jumped in the 1980s when beer companies began to leverage Cinco de Mayo in marketing campaigns.
***
The antitrust watchdogs at the Federal Trade Commission (FTC) just tore into Facebook saying the agency has caught the social media giant violating kids’ data privacy for profit — for the third time. Now the FTC has had enough. In a new proposal to protect kids, the agency wants to ban the platform from ever monetizing youth data again. In a ferocious rebuke, the FTC said Facebook defied its direct order to protect kids’ online privacy and broke the promise the company made in a 2019 consent order when it was forced to pay a $5 billion penalty for violating a 2012 order.
***
Here’s where the major indexes ended:
The S&P 500 Index was down 29.53 points (0.7%) at 4061.22; the Dow Jones industrial average was down 286.50 (0.9%) at 33,127.74; the NASDAQ Composite was down 58.93 (0.5%) at 11,966.40.
The 10-year Treasury yield was down about 4 basis points at 3.364%.
CBOE’s Volatility Index was up 1.74 at 20.08.
Financial stocks led the market’s declines, with the KBW Regional Banking index sinking nearly 3% to its lowest level since November 2020. Transportation stocks were also under pressure as banking sector troubles exacerbated recession concerns. Crude oil futures initially extended this week’s slump, dropping under $64 a barrel to a 17-month low before rebounding.
Under law, financial advisors and planners must provide you with a form ADV Part II or a brochure that covers the same information. Even if a brochure is provided, ask for the ADV. While it is acceptable, even desirable, for the brochure to be easier to read than the ADV, the ADV is what is filed with the appropriate state or SEC. If the brochure reads more like a slick sales brochure or the information in the brochure glosses over the items on the ADV to a high degree, one should consider eliminating the advisor from consideration.
Registering with a state or SEC gives an advisor a fiduciary duty to the client. This is a high standard under the law.
There are several types of advisors who are exempt from registering and filing an ADV.
First, there are registered representatives (brokers). Brokers have a fiduciary responsibility to their firms regardless of whether they are statutory employees or independent contractors. Not the client.
Second are attorneys and accountants whose advice is “incidental” to their legal or accounting practices. But, why would one hire someone whose advice is “incidental” to his primary profession? A top-notch advisor is a full-time professional and should be registered. One should insist that their advisor be registered.
The ADV will describe the advisor’s background and employment history, including any prior disciplinary issues. It will describe the ownership of the firm and outline how the firm and advisor are compensated. Any referral arrangements will be described. If an advisor has an interest in any of the investments to be recommended, it must be listed as well as the fee schedule. There is also a description of the types of investments recommended and the types of research information that is used.
ASSESSMENT: A review of the ADV should result in an alignment of what the advisor said during the interview and what is filed with the regulators. If there is a clear discrepancy, choose another advisor. If it is unclear, discuss the issue with the advisor.
Your thoughts and comments are appreciated.
SEC Headquarters 100 F Street, NE Washington, DC 20549 (202) 942-8088
In 1972, husbands were the primary or sole breadwinners in 85% of U.S. married households, while 5% of wives made all or most of the money, and 11% of married couples had equal salaries. According to the Pew Research Center, things have changed quite a bit in 50 years.
Today, 55% of husbands are now the primary or sole financial supporters (a 35% drop). Financially egalitarian marriages have risen to 29% (more than a 160% increase), and 16% of married women provide the lioness’ share of family finances (a 220% increase).
Markets: The relative calm after JPMorgan scooped up First Republic Bank lasted all of…one day. Two other West Coast lenders, PacificWest and Western Alliance, both tumbled in a sign investors still smell blood among regional banks.
Economy: Happy Fed Decision Day to all who celebrate. With inflation sizzling at still-uncomfortably high levels, Chair Jerome Powell is expected to announce the central bank’s 10th straight interest rate hike this afternoon. But many economists expect this rate increase could be the grand finale.
Layoffs jump to the highest level since late 2020. The number of job openings in the US dropped to a nearly two-year low in March, and layoffs increased to their highest point since December 2020, the Labor Department revealed yesterday. In this “bad news is good news” economic environment, the Fed will be pleased that the boiling-hot labor market is cooling off. It means less pressure on inflation and more justification to pause hiking rates.
The S&P 500® Index was down 48.29 points (1.2%) at 4119.58; the Dow Jones industrial average was down 367.17 (1.1%) at 33,684.53; the NASDAQ Composite was down 132.09 (1.1%) at 12,080.51.
The 10-year Treasury yield was down about 15 basis points at 3.428%.
CBOE’s Volatility Index was up 1.67 at 17.77.
Regional banks led the declines, with the KBW Regional Banking index sinking more than 5% to its lowest level since late 2020.
Energy stocks were also weaker as crude oil futures extended a slide, dropping under $72 a barrel to their lowest level in more than five weeks. Small-caps also slumped, with the Russell 2000 index down 2%.
***
More specifically, ahead of the Federal Reserve’s latest policy decision and fresh earnings results:
By 6:45pm ET (10:45pm GMT) Dow Jones Futures were flat while S&P 500 Futures and NASDAQ 100 Futures eased 0.1% apiece.
In extended deals, Advanced Micro Devices Inc (NASDAQ:AMD) fell 6.5% after reporting Q1 EPS of $0.60 versus $0.56 expected on revenues of $5.4 billion versus $5.3 billion expected. Looking ahead, the company forcasted Q2 2023 revenue in the range of $5-5.6 billion versus $5.49 billion expected.
Ford Motor (NYSE:F) slipped 1.6% after the company reported Q1 EPS of $0.63, beating expectations of $0.42,ewhile revenue was reported at $39.1 billion versus $37.4 billion expected.
Sprout Social (NASDAQ:SPT) dipped 17.4%, reporting Q1 EPS of $0.06, beating expected losses of $0.01 per share, while revenue came in at $75.2 million versus $75.07 million expected.
Treasury Secretary Janet Yellen warned yesterday that the US could run out of money to pay all its bills as early as June 1st if Congress does not raise or suspend the debt limit before then. The US’ first-ever default would be disastrous for financial markets, economists say.
***
Meanwhile, Europe’s painful inflation has inched higher, extending the squeeze on households and keeping pressure on the European Central Bank to unleash what could be another large interest rate increase. Consumer prices in the 20 countries using the euro currency jumped 7% in April from a year earlier, just up from the annual rate of 6.9% in March, the European Union statistics agency Eurostat said today. Food price inflation eased a little, falling to an annual rate of 13.6% from March’s 15.5%, while energy prices rose a more modest 2.5%. Core inflation, which excludes volatile food and fuel, slowed slightly but was still high at 5.6%, underlining the expectation that the ECB will press ahead with its campaign to beat inflation into submission with rate hikes.
Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it. The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so! It is the type of definitive financial lifestyle planning book we often seek, but seldom find. —LeRoy Howard MA CMPTM,Candidate and Financial Advisor, Fayetteville, North Carolina I taught diagnostic radiology for over a decade. The physician-focused niche information, balanced perspectives, and insider industry transparency in this book may help save your financial life. —Dr. William P. Scherer MS, Barry University, Ft. Lauderdale, Florida This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs. It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional. —Parin Khotari MBA,Whitman School of Management, Syracuse University, New York In today’s healthcare environment, in order for providers to survive, they need to understand their current and future market trends, finances, operations, and impact of federal and state regulations. As a healthcare consulting professional for over 30 years supporting both the private and public sector, I recommend that providers understand and utilize the wealth of knowledge that is being conveyed in these chapters. Without this guidance providers will have a hard time navigating the supporting system which may impact their future revenue stream. I strongly endorse the contents of this book.—Carol S. Miller BSN MBA PMP,President, Miller Consulting Group, ACT IAC Executive Committee Vice-Chair at-Large, HIMSS NCA Board Member This is an excellent book on financial planning for physicians and health professionals. It is all inclusive yet very easy to read with much valuable information. And, I have been expanding my business knowledge with all of Dr. Marcinko’s prior books. I highly recommend this one, too. It is a fine educational tool for all doctors.—Dr. David B. Lumsden MD MS MA,Orthopedic Surgeon, Baltimore, Maryland There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them. —Dr. Jason Dyken MD MBA,Dyken Wealth Strategies, Gulf Shores, Alabama I plan to give a copy of this book written ‘by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic. —Alexander Naruska CPA,Orlando, Florida
Health professionals are small business owners who need to apply their self-discipline tactics in establishing and operating successful practices. Talented trainees are leaving the medical profession because they fail to balance the cost of attendance against a realistic business and financial plan. Principles like budgeting, saving, and living below one’s means, in order to make future investments for future growth, asset protection, and retirement possible are often lacking. This textbook guides the medical professional in his/her financial planning life journey from start to finish. It ranks a place in all medical school libraries and on each of our bookshelves. —Dr. Thomas M. DeLauro DPM,Professor and Chairman – Division of Medical Sciences, New York College of Podiatric Medicine
Physicians are notoriously excellent at diagnosing and treating medical conditions. However, they are also notoriously deficient in managing the business aspects of their medical practices. Most will earn $20-30 million in their medical lifetime, but few know how to create wealth for themselves and their families. This book will help fill the void in physicians’ financial education. I have two recommendations: 1) every physician, young and old, should read this book; and 2) read it a second time! —Dr. Neil Baum MD,Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, Louisiana
I worked with a Certified Medical Planner™ on several occasions in the past, and will do so again in the future. This book codified the vast body of knowledge that helped in all facets of my financial life and professional medical practice. —Dr. James E. Williams DABPS, Foot and Ankle Surgeon, Conyers, Georgia
This is a constantly changing field for rules, regulations, taxes, insurance, compliance, and investments. This book assists readers, and their financial advisors, in keeping up with what’s going on in the healthcare field that all doctors need to know. —Patricia Raskob CFP® EA ATA, Raskob Kambourian Financial Advisors, Tucson, Arizona I particularly enjoyed reading the specific examples in this book which pointed out the perils of risk … something with which I am too familiar and have learned (the hard way) to avoid like the Black Death. It is a pleasure to come across this kind of wisdom, in print, that other colleagues may learn before it’s too late— many, many years down the road. —Dr. Robert S. Park MD, Robert Park and Associates Insurance, Seattle, Washington
Although this book targets physicians, I was pleased to see that it also addressed the financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable. —Nurse Cecelia T. Perez RN, Hospital Operating Room Manager, Ellicott City, Maryland
Personal financial success in the PP-ACA era will be more difficult to achieve than ever before. It requires the next generation of doctors to rethink frugality, delay gratification, and redefine the very definition of success and work–life balance. And, they will surely need the subject matter medical specificity and new-wave professional guidance offered in this book. This book is a ‘must-read’ for all health care professionals, and their financial advisors, who wish to take an active role in creating a new subset of informed and pioneering professionals known as Certified Medical Planners™. —Dr. Mark D. Dollard FACFAS, Private Practice, Tyson Corner, Virginia As healthcare professionals, it is our Hippocratic duty to avoid preventable harm by paying attention. On the other hand, some of us are guilty of being reckless with our own financial health—delaying serious consideration of investments, taxation, retirement income, estate planning, and inheritances until the worry keeps one awake at night. So, if you have avoided planning for the future for far too long, perhaps it is time to take that first step toward preparedness. This in-depth textbook is an excellent starting point—not only because of its readability, but because of his team’s expertise and thoroughness in addressing the intricacies of modern investments—and from the point of view of not only gifted financial experts, but as healthcare providers, as well … a rare combination. —Dr. Darrell K. Pruitt DDS, Private Practice Dentist, Fort Worth, Texas This text should be on the bookshelf of all contemporary physicians. The book is physician-focused with unique topics applicable to all medical professionals. But, it also offers helpful insights into the new tax and estate laws, fiduciary accountability for advisors and insurance agents, with investing, asset protection and risk management, and retirement planning strategies with updates for the brave new world of global payments of the Patient Protection and Affordable Care Act. Starting out by encouraging readers to examine their personal ‘money blueprint’ beliefs and habits, the book is divided into four sections offering holistic life cycle financial information and economic education directed to new, mid-career, and mature physicians.
This structure permits one to dip into the book based on personal need to find relief, rather than to overwhelm. Given the complexity of modern domestic healthcare, and the daunting challenges faced by physicians who try to stay abreast of clinical medicine and the ever-evolving laws of personal finance, this textbook could not have come at a better time. —Dr. Philippa Kennealy MD MPH, The Entrepreneurial MD, Los Angeles, California Physicians have economic concerns unmatched by any other profession, arriving ten years late to the start of their earning years. This textbook goes to the core of how to level the playing field quickly, and efficaciously, by a new breed of dedicated Certified Medical Planners™. With physician-focused financial advice, each chapter is a building block to your financial fortress. —Thomas McKeon, MBA, Pharmaceutical Representative, Philadelphia, Pennsylvania An excellent resource … this textbook is written in a manner that provides physician practice owners with a comprehensive guide to financial planning and related topics for their professional practice in a way that is easily comprehended. The style in which it breaks down the intricacies of the current physician practice landscape makes it a ‘must-read’ for those physicians (and their advisors) practicing in the volatile era of healthcare reform. —Robert James Cimasi, MHA ASA FRICS MCBA CVA CM&AA CMP™, CEO-Health Capital Consultants, LLC, St. Louis, Missouri Rarely can one find a full compendium of information within a single source or text, but this book communicates the new financial realities we are forced to confront; it is full of opportunities for minimizing tax liability and maximizing income potential. We’re recommending it to all our medical practice management clients across the entire healthcare spectrum. —Alan Guinn, The Guinn Consultancy Group, Inc., Cookeville, Tennessee Dr. David Edward Marcinko MBA CMP™ and his team take a seemingly endless stream of disparate concepts and integrate them into a simple, straightforward, and understandable path to success. And, he codifies them all into a step-by-step algorithm to more efficient investing, risk management, taxation, and enhanced retirement planning for doctors and nurses. His text is a vital read—and must execute—book for all healthcare professionals and physician-focused financial advisors. —Dr. O. Kent Mercado, JD, Private Practitioner and Attorney, Naperville, Illinois
Kudos. The editors and contributing authors have compiled the most comprehensive reference book for the medical community that has ever been attempted. As you review the chapters of interest and hone in on the most important concerns you may have, realize that the best minds have been harvested for you to plan well… Live well. —Martha J. Schilling; AAMS® CRPC® ETSC CSA, Shilling Group Advisors, LLC, Philadelphia, Pennsylvania I recommend this book to any physician or medical professional that desires an honest no-sales approach to understanding the financial planning and investing world. It is worthwhile to any financial advisor interested in this space, as well. —David K. Luke, MIM MS-PFP CMP™, Net Worth Advisory Group, Sandy, Utah Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisor. I highly recommend it and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done. —Ken Yeung MBA CMP™, Tseung Kwan O Hospital, Hong Kong I’ve seen many ghost-written handbooks, paperbacks, and vanity-published manuals on this topic throughout my career in mental healthcare. Most were poorly written, opinionated, and cheaply produced self-aggrandizing marketing drivel for those agents selling commission-based financial products and expensive advisory services. So, I was pleasantly surprised with this comprehensive peer-reviewed academic textbook, complete with citations, case examples, and real-life integrated strategies by and for medical professionals. Although a bit late for my career, I recommend it highly to all my younger colleagues … It’s credibility and specificity stand alone. —Dr. Clarice Montgomery PhD MA,Retired Clinical Psychologist In an industry known for one-size-fits-all templates and massively customized books, products, advice, and services, the extreme healthcare specificity of this text is both refreshing and comprehensive. —Dr. James Joseph Bartley, Columbus, Georgia
My brother was my office administrator and accountant. We both feel this is the most comprehensive textbook available on financial planning for healthcare providers. —Dr. Anthony Robert Naruska DC,Winter Park, Florida
Eli Lilly (NYSE: LLY) investors continued to be in a good mood about their stock on Friday. Following the estimates-beating first quarter reported by the big pharmaceutical company the previous morning, they traded the shares up by 1.4% on the final trading day of the week. That eclipsed the 0.8% gain of the S&P 500 index.
Researchers at MIT have created a new type of tabletop printer that spits out vaccine doses on demand in the form of thumbnail-size microneedle patches. Once scaled, this mobile technology could produce hundreds of doses per day, revolutionizing pandemic response. And in a boon for warmer or more remote parts of the world, the vaccine patches can be stored at room temperature for months before they’re slapped on—no refrigeration or professional administering required.
Compensation pay for US workers picked up in the first three months of the year, showing that a major source of inflationary pressure persists and cementing the path for an interest rate hike at the Federal Reserve’s meeting next week. The Employment Cost Index, released Friday by the Bureau of Labor Statistics, showed that workers were paid 1.2% more in wages and benefits in the first quarter from the prior three-month period. That’s up from analysts’ expectations of 1.1%.
Markets: Stocks rose yesterday, finishing strong to give the Dow its best month since January. But First Republic Bank tanked again as rumors flew about its fate, again.
Economy: For all the Fed watchers, new data released makes it look like another rate hike could be in store next week. The data shows wages are still trending upward, and one of the Fed’s favorite inflation measures rose slightly last month.
Here’s where markets ended.
The S&P 500 Index was up 34.13 (0.8%) at 4169.48, a nearly three-month high; the Dow Jones industrial average was up 272.00 (0.8%) at 34,098.16; the NASDAQ Composite was up 84.35 (0.7%) at (12,226.58.
The 10-year Treasury yield was down about 9 basis points at 3.437%.
CBOE’s Volatility Index was down 1.27 at 15.76.
Energy companies were among the strongest sectors today with help from a rally in crude oil futures. Transportation and financial stocks were also strong. Utilities and consumer discretionary sectors were among the weakest sectors.
A government report on U.S. economic output in the first quarter will shed light on how consumers and businesses are faring under high inflation, rising interest rates and the onset of banking problems. Consumer spending, the primary driver of growth, and hiring were surprisingly strong at the start of the year, but more recently slowed as the Federal Reserve continued raising interest rates to cool the economy and curb rapid price increases. TO WIT:
***
Meta’s “Year of Efficiency” is off to a strong start: After three straight quarters of falling revenue last year, the company saw an uptick in ad sales for a 3% revenue jump from Q1 2022. Profits were down, but the company still beat expectations, and Facebook gained users again after losses last year. But not all of Mark Zuckerberg’s dreams are coming true—the company’s Metaverse unit lost almost $4 billion last quarter.
Chipotle—which hit near all-time highs after saying customers kept coming back for burrito bowls despite price increases.
The UK’s competition regulator blockedMicrosoft’s bid to acquire the Call of Duty-maker saying it would hurt competition in the cloud gaming sector. The move came as a shock because the regulator had previously said Microsoft had assuaged its concerns about the console gaming market. The decision, which Microsoft plans to appeal, puts a strain on the deal while the companies wait for competition decisions from the EU and the US, where the FTC has already sued to scuttle it.
Finally, while egg prices have fallen dramatically, one sector of the economy remains stubbornly expensive: rents.
In the latest consumer price index report, the shelter category (aka rents) was the largest contributor by far to overall inflation. And despite moderating in recent months, rent growth remains 17% higher than 2021 levels.
Short-term goals (less than 12 months) require liquidity or short-term assets. These assets include cash, checking and saving accounts, certificates of deposit, and money market accounts. These accounts have two things in common. The principal is guaranteed from risk of loss, and pay a very low interest rate. As an investment, they are considered substandard and one would only keep what is actually needed for liquidity purposes in these accounts.
[B] Long-Term Assets
Longer-term assets (more than 12 months) include real estate, mutual funds, retirement plans, stocks, and life insurance cash value policies. Bonds may also be an appropriate long-term investment asset for a number of reasons, for example, if you are seeking a regular and reliable stream of income or if you have no immediate need for the amount of the principal invested. Bonds also can be used to diversify your portfolio and reducing the overall risk that is inherent in stock investments.
[C] Short-Term Liabilities
Short-term liabilities (less than 12 months) include credit card debt, utility bills, and auto loans or leasing. When a young doctor leaves residency and starts practice, the foremost concern is student debt. This is an unsecured debt that is not backed by any collateral, except a promise to pay. There are recourses that an unsecured creditor can take to recoup the bad debt. Usually, if the unsecured creditor is successful obtaining a judgment, it can force wages to be garnished, and the Department of Education can withhold up to ten percent of a wages without first initiating a lawsuit, if in default. It is also probable that young medical professionals have been holding at least one credit card since their sophomore year in college. Credit card companies consider college student the most lucrative target market and medical students hold their first card for an average of fifteen years. There are several other types of other unsecured debt, including department store cards, professional fees, medical and dental bills, alimony, child support, rent; utility bills, personal loans from relatives, and health club dues, to name a few.
[D] Long-Term Liabilities
A secured debt, on the other hand, is debt that is pledged by a specific property. This is a collateralized loan. Generally, the purchased item is pledged with the proceeds of the loan. This would include long-term liabilities (more than 12 months) such as a mortgage, home equity loan, or a car loan. Although the creditor has the ability to take possession of your property in order to recover a bad debt, it is done very rarely. A creditor is more interested in recovering money. Sometimes, when borrowing money, there may be a requirement to pledge assets that are owned prior to the loan.
For example, a personal loan from a finance company requires that you pledge all personal property such as your car, furniture, and equipment. The same property may become subject to a judicial lien if you are sued and a judgment is made against you. In this case, you would not be able to sell or pledge these assets until the judgment is satisfied.
A common example of a lien would be from unpaid federal, state or local taxes. Doctors can be found personally liable for unpaid payroll taxes of employees in their professional corporations. Be aware that some assets and liabilities defy short or long-term definition. When this happens, simply be consistent in your comparison of financial statements, over time.
[E] Personal Physician Net Worth
Once the value of all personal assets and liabilities is known, net worth can be determined with the following formula: Net worth = assets minus liabilities. Obviously, higher is better. In The Millionaire Next Door, Thomas H. Stanley, PhD, and William H. Danko give the following benchmark for net worth accumulation. Although conservative for physicians of a past generation, it may be more applicable in the future because of current managed care environment.
Here is the guide: Multiple your age by your annual pre-tax income from all sources – except inheritances – and divide by ten.
Real-Life Medical Example:As an HMO pediatrician, Dr. Curtis earned $ 60,000 last year. So, if she is 35, her net worth should be at least $ 210,000.
How do you get to that point? In a word, consume less, save more and watch the student loans. Stanley and Danko found that the typical millionaire set aside 15 percent of earned income annually and has enough invested to survive 10 years, at current income levels if he stopped working. Now, if Dr. Curtis lost her job tomorrow, how long could she pay herself the same salary?
[F] Common Liability Management Mistakes
A common liability management mistake is not recognizing when you are heading for trouble. If doctors are paying only the minimum payments on credit card debt, while continuing to charge purchases at a rate faster than the pay-down, trouble is brewing. If you don’t categorize your debt, you could find yourself paying down non-priority debt while ignoring priority debt.
A priority debt is one that is essential or subject to serious consequences, if not paid. Examples include rent, mortgage payments, utility bills, child support, car payments, unpaid taxes, and other secured debt. If in one month, a doctor had to choose between paying his accounting bill or his rent, it would be essential to pay the rent.
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
First quarter earnings from big lending institutions painted something of a mixed picture, with Bank of America posting healthy returns as Goldman Sachs on Tuesday saw headwinds from its loan portfolio.
The following is a round-up of yesterday’s market activity:
The S&P 500 Index was up 3.55 points (0.1%) at 4154.87; the Dow Jones industrial average was down 10.55 at 33,976.63; the NASDAQ Composite was down 4.31 at 12,153.41.
The 10-year Treasury yield was down about 2 basis points at 3.574%.
CBOEs Volatility Index was down 0.12 at 16.83.
Small-cap stocks, which tend to suffer more from recession concerns than their large-cap peers, were among the weakest performers with the Russell 2000 falling about 0.4%. Communications services and utilities were laggards among S&P 500 sectors, while industrials and consumer staples were stronger.
Volatility as measured by the VIX continued to drop to the lowest levels since late 2021.
As human beings, our brains are booby-trapped with psychological barriers that stand between making smart financial decisions and making dumb ones. The good news is that once you realize your own mental weaknesses, it’s not impossible to overcome them.
In fact, Mandi Woodruff, a financial reporter whose work has appeared in Yahoo! Finance, Daily Finance, The Wall Street Journal, The Fiscal Times and the Financial Times among others; related the following mind-traps in a September 2013 essay for the finance vertical Business Insider; as these impediments are now entering the lay-public zeitgeist.
***
Anchoring happens when we place too much emphasis on the first piece of information we receive regarding a given subject. For instance, when shopping for a wedding ring a salesman might tell us to spend three months’ salary. After hearing this, we may feel like we are doing something wrong if we stray from this advice, even though the guideline provided may cause us to spend more than we can afford.
Myopia makes it hard for us to imagine what our lives might be like in the future. For example, because we are young, healthy, and in our prime earning years now, it may be hard for us to picture what life will be like when our health depletes and we know longer have the earnings necessary to support our standard of living. This short-sightedness makes it hard to save adequately when we are young, when saving does the most good.
Gambler’s fallacy occurs when we subconsciously believe we can use past events to predict the future. It is common for the hottest sector during one calendar year to attract the most investors the following year. Of course, just because an investment did well last year doesn’t mean it will continue to do well this year. In fact, it is more likely to lag the market.
Avoidance is simply procrastination. Even though you may only have the opportunity to adjust your health care plan through your employer once per year, researching alternative health plans is too much work and too boring for us to get around to it. Consequently, we stick with a plan that may not be best for us.
Loss aversion affected many investors during the stock market crash of 2008. During the crash, many people decided they couldn’t afford to lose more and sold their investments. Of course, this caused the investors to sell at market troughs and miss the quick, dramatic recovery.
Overconfident investing happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. Data convincingly shows that people who trade most often underperform the market by a significant margin over time.
Mental accounting takes place when we assign different values to money depending on where we get it from. For instance, even though we may have an aggressive saving goal for the year, it is likely easier for us to save money that we worked for than money that was given to us as a gift.
Herd mentality makes it very hard for humans to not take action when everyone around us does. For example, we may hear stories of people making significant profits buying, fixing up, and flipping homes and have the desire to get in on the action, even though we have no experience in real estate.
A rally on Wall Street yesterday is lifting stocks to their highest level in almost two months following the latest sign that inflation continues to cool. Yesterday’s report showed that prices paid to producers last month were 2.7% higher than a year earlier, the lowest inflation level there in more than two years. The hope on Wall Street is that easier inflation on the wholesale level will not only support profits for companies but also flow through to cooler inflation for consumers. A day earlier, a separate report said inflation for consumers slowed to 5%.
Inflation and how high the Federal Reserve will hike interest rates to tame it have been at the center of Wall Street’s struggles for more than a year. The Fed has hiked rates at such a feverish pace over the last year that it’s already slowed parts of the economy and caused strains to appear in the banking system.
And so, stocks climbed on the cooler-than-expected PPI, and perhaps some optimism around the Q1 earnings season, with several big banks reporting Friday. However, expectations around Fed policy didn’t budge much.
Bond yields were little changed and markets still see a 70% probability of the Fed enacting a quarter-point rate increase in May, according to the CME FedWatch tool.
The following is a round-up of yesterday’s market activity:
The S&P 500 Index was up 54.27 points (1.3%) at 4146.22; the Dow Jones industrial average was up 383.19 (1.1%) at 34,029.69; the NASDAQ Composite was up 236.93 (2.0%) at 12,166.27.
The 10-year Treasury yield was up about 3 basis points at 3.447%.
Earnings before interest, taxes, depreciation, and amortization
A company’s earnings before interest, taxes, depreciation, and amortization is an accounting measure calculated using a company’s earnings, before interest expenses, taxes, depreciation, and amortization are subtracted, as a proxy for a company’s current operating profitability. Though often shown on an income statement, it is not considered part of the Generally Accepted Accounting Principles by the SEC.
A 2020 analysis of Doximity’s physician compensation data found that men physicians make an estimated $2 million more than women over the course of their careers.
Men physicians outearned women physicians by at least 10% across all specialties, except pediatric cardiology (9.2%) and nuclear medicine (3%).
Specialties with the largest gender pay gaps were: oral and maxillofacial surgery ($568,789 vs. $395,687), pediatric pulmonology ($282,272 vs. $227,958), allergy and immunology ($329,634 vs. $268,938), urology ($515,850 vs. $424,733), and ophthalmology ($468,515 vs. $387,295).
Specialities with the smallest gender pay gaps were: nuclear medicine ($394,231 vs. $382,431), pediatric cardiology ($334,384 vs. $303,622), pediatric gastroenterology ($293,771 vs. $264,135) hematology ($358,736 vs. $320,938), and medicine/pediatrics ($283,034 vs. $253,019).
This is part one of the post winter seasonal letter I wrote to IMA clients, sharing my thoughts about the economy and the market. I tried something I’ve never done before. Instead of conveying my message through storytelling, I tried to compress my thoughts into short sentences. I summarized some 50,000 words into about 1,000 (a compression ratio of 50 to 1!).
Markets: The NASDAQ extended its losing streak for a third day yesterday amidst a mixed showing for stocks overall. Among the tech stocks having a rough day was cybersecurity giant Zscaler, as investors got new data suggesting the labor market may be cooling (setting off recession jitters again).
***
This week’s economic numbers “all point to a softening economy,” but not necessarily a “soft landing,” says Kevin Gordon, senior investment strategist at the Schwab Center for Financial Research. An economic slowdown that averts recession “is what the Fed is looking for, but the market is saying today—with both stock prices and bond yields lower—that recession fears are outweighing hopes for a soft landing,” Kevin says.
The S&P 500® Index fell 10.22 points (0.3%) to 4090.38; the Dow Jones industrial average rose 80.34 (0.2%) to 33482.72; the NASDAQ Composite fell 129.47 (1.1%) to 11996.86.
The 10-year Treasury yield fell about 3 basis points to 3.309%.
CBOEs Volatility Index was up 0.12 at 19.12.
Among S&P 500 sectors, consumer discretionary and industrial stocks led declines. One bright spot was the healthcare sector, which jumped nearly 2%, helped by gains in Johnson & Johnson (JNJ) and Eli Lilly (LLY). Recession concerns weighed particularly heavily on small-cap stocks, as the Russell 2000 index dropped near a two-week low. WTI crude futures fell slightly but remained above $80 a barrel and near two-month highs.
Gold futures extended this week’s rally and ended at a 13-month high.
Would you like to present your self or firm, your strategic competitive advantage, and your value proposition to the medical community?
Would you like to share some unique financial planning, financial advisory or health economics pearls with your colleagues?
Would you like to see a new financial product or service in action before you start using it in your practice, or recommending it to physician clients?
Would you like to introduce yourself and prospect to the HNW medical community, for free?
If so …
Join your ME-P peers and colleagues. Get free access to on-demand videos and other presentations from leading financial advisors [FAs] and brought to you by www.MedicalExecutivePost.com.
The ME-P is your source for the best online-exclusive content in the financial advisory marketing, and financial planning e-prospecting space, for all healthcare professionals [physicians, podiatrists, osteopaths, dentists, chiropractors, nurses, medical CXOs, etc].
How to Submit a Video
To submit a personal or product presentation video [pod-cast], sponsor a video [pod-cast], or inquire about specific advertising on the ME-P, please contact Ann Miller RN MHA at: 770.448.0769 or MarcinkoAdvisors@msn.com
Video Formats
Acceptable 5-12 minute video formats include: Flash (in either SWF or FLA), MPEG, MP4, QuickTime or AVI. Submission of a podcast/video does not guarantee publishing on the ME-P website. FA submitted videos are subject to review by the Executive Editor. Company submitted videos are subject to review by the Publisher and Executive Editor.
SAMPLE PODCAST
In this encore podcast, Somnath Basu PhD MBA examines how the recent economic turmoil has changed financial planning clients’ attitudes and expectations.
ME-P and iMBA Inc pledges always to respect the privacy and anonymity of its users and participants. The information (the names, email addresses or any other contact information, personal or financial data) provided to us by our visitors in their registrations and communications with us is securely stored and not shared with any third party. We are committed to working with the Internet community in cultivating and maintaining trust between all its members.
All about the Medical Executive-PostBusiness Model
***
One of the questions we receive most often from readers of the Medical Executive-Post is how can we “afford” to give away so much content for free. Or stated another way, “how do we get paid for all of this?”
The simple answer is that we know many (or even most) of you will simply take the ideas that we share and implement them yourself. Do-It-YourSelfers can always simply purchase our texts, books and peer reviewed handbooks redacted in more than a thousand, medical, law, business and graduate schools, as well as the Library of Congress,Institute of Health and Library of Congress.
On the other hand, some of you will realize you need some additional help.
For example:
Maybe as a financial advisor you’re “stuck” in your financial planning business and recognize that some outside assistance is necessary to help you get to the next level of niche specificity thru our Certified Medical Planner™ chartered certification program designation. Helping physicians of all specialty types in a fiduciary focused manner is the proverbial Win-Win for all concerned.
OR, perhaps you are seeking a glossary of terms and definitions in heath economics, finance, accounting, insurance, managed care, health information technology and security; found in our Health Dictionary Series Wiki Project? Free and print versions are available.
OR, as a doctor maybe your medical practice is growing so much you just hit a wall where you don’t have time to do it all for your patients. After all, with only “so much” time available every day and week, it’s vital to delegate or outsource anything that isn’t really core to your practice and management skill set.
OR, maybe you are even starting, buying or selling your medical practice and need our financial and valuation services. Part (1) – Part (2) – Part (3) Financial, estate, investing and retirement planning services are also available.
OR, you may just need a second informed opinion about a topic not listed; there are a myriad of issues to consider in the competitive ecosystem today.
So, in the meantime, I hope that the ME-P content continues to be helpful food for thought, and perhaps we’ll have an opportunity to cross paths soon at a future conferences or podcasts. Feel free to invite us to speak at your own seminar/podcast online V-log, as well.
Analysts at Morgan Stanley downgraded Charles Schwab Corp (NYSE: SCHW) on Tuesday, citing concerns over cash sorting and regulatory changes. But, Schwab CEO Walt Bettinger recently said that the company’s banking unit had enough liquidity to cover if 100% of its bank deposits ran off without having to sell a single security — Morgan Stanley says otherwise. Schwab’s recent performance has not been up to Morgan Stanley’s expectations, with customers moving cash out of sweep accounts into money market funds at a rate twice that which the bank had been modeling.
The S&P 500® Index rose 23 points (0.57%) to 4050.84; the Dow Jones industrial average was up 141 points (0.43%) at 32859.03; the NASDAQ Composite was up 87 points (0.73%) at 12013.47.
The 10-year Treasury yield slipped 2 basis points to 3.555%.
CBOE’s Volatility Index was little changed at 19.14.
Colleagues know that I enjoy personal coaching and public speaking and give as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world. All in a Corona safe environment.
MARCINKO in the METAVERSE
These include lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, end-note lectures at city and statewide financial coalitions, and annual lectures for a variety of internal yearly meetings.
A rare alignment of five planets will be visible in the night sky this week, but this Tuesday [tonight] evening will be your best bet. Just head outside right after sunset, look west, and you’ll see Mercury, Venus, Mars, Jupiter, and Uranus appear to line up in an arc shape below the crescent moon. Anyone on Earth should be able to see it, even if you’re living in a city with light pollution.
The word syzygy is often used to describe interesting configurations of astronomical objects in general. For example, one such case occurred on March 21, 1894, around 23:00 GMT, when Mercury transited the Sun as would have been seen from Venus, and Mercury and Venus both simultaneously transited the Sun as seen from Saturn. It is also used to describe situations when all the planets are on the same side of the Sun although they are not necessarily in a straight line, such as on March 10, 1982.
***
Here’s how the mixed markets fared yesterday on Monday:
The S&P 500® Index was up 6.54 points (0.16%) at 3977.53; the Dow Jones industrial average was up 194.55 points (0.6%) at 32432.08; the NASDAQ Composite was down 55.12 points (0.47%) at 11768.84.
The 10-year Treasury yield was up around 17 basis points at 3.542%.
CBOEs Volatility Index was down 1.05 points (4.8%) at 20.71.
Outside of the financial sector, energy also had a good day Monday, as the apparent return to calm in the world of banks helped ease concerns about the economy. Oil prices recovered, with West Texas Intermediate rising more than 5% to roughly $73.
Florida is pulling $2 billion from BlackRock in the largest divestment ever made as part of the growing vendetta against Environmental, Social, and Governance (ESG) investing practices. Florida Governor Ron DeSantis and other Republican leaders claim that by taking ESG standards into account when making investment decisions, the firm isn’t prioritizing the bottom line. But, for a few years, things were good. In 2020 and 2021, ESG funds outperformed the market by ~4.3%.
DEFINITION: According to Wikipedia, ESG (environmental, social, and corporate governance) data reflect the externalities (costs to others) an organization is generating with respect to the environment, to society and to corporate governance. ESG data can be used by investors to assess the material risk the organization is taking and by the organization itself as metrics for strategic and managerial purposes. Investors may also use ESG data beyond assessing material risks to the organization in their evaluation of enterprise value, specifically by designing models based on assumptions that the identification, assessment and management of sustainability-related risks and opportunities in respect to all organizational stakeholders leads to higher long-term risk-adjusted return. Organizational stakeholders include but not limited to customers, suppliers, employees, leadership, and the environment.
Since 2020, there has been accelerating interest in overlaying ESG data with the Sustainable Development Goals (SDGs), developed based on work by United Nations beginning in the 1980s.
The term ESG was popularly used first in a 2004 report titled “Who Cares Wins”, which was a joint initiative of financial institutions at the invitation of UN. In less than 20 years, the ESG movement has grown from a corporate social responsibility initiative launched by the United Nations into a global phenomenon representing more than US$30 trillion in assets under management. In the year 2019 alone, capital totaling US$17.67 billion flowed into ESG-linked products, an almost 525 percent increase from 2015, according to Morningstar, Inc.. Critics claim ESG linked-products have not had and are unlikely to have the intended impact of raising the cost of capital for polluting firms, and have accused the movement of greenwashing.
DeSantis ran his most recent campaign on fighting the “woke ideology” he believes is infiltrating the state. As part of the fight, Florida passed a resolution in August that said ESG standards should be ignored when investing state funds.
And he’s not the only one:
Other Republican-controlled states, including Missouri and Louisiana, have moved almost $1.3 billion away from BlackRock for similar reasons.
Texas flagged BlackRock as a financial firm that boycotts the state’s energy industry (something BlackRock has denied).
Meanwhile, Democrats aren’t happy either…they criticize BlackRock and ESG investing in general for not going far enough (and for using lax standards that let oil giants onto lists of ESG investments).
Bottom line: According to the Morning Brew, BlackRock and Florida are now cursed to yell “How could you prioritize politics over returns?” back and forth for eternity, and the debate over ESG investing is far from over. Republicans are poised to take over the House—after a campaign season that BlackRock poured record cash into—so we’re likely to see more drama play out at the federal level soon.
Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 