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].
Google (GOOG, GOOGL) just announced several new AI-powered features for its Search, Maps, and Lens apps. The announcement comes just a day after rival Microsoft (MSFT) rolled out a new version of its Bing search engine complete with generative AI capabilities, bringing a rare threat to Google’s search supremacy.
But, shares of Google parent company Alphabet were down more than 7% today as investors expressed skepticism about these new features.
Dr. David Edward Marcinko works with doctors, nurses, technicians and healthcare professionals who struggle with professional disillusionment, burnout, financial distress and an unbalanced life–all of which can happen at any stage of a medical career. Through our coaching sessions, medical and healthcare professionals can achieve a more meaningful, purposeful, and flourishing life.
On December 19, 2022, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published Advisory Opinion (AO) No. 22-20, analyzing the utilization of nurse practitioners (NPs) in lieu of attending physicians within medical units. The OIG concluded that the arrangement utilizing NPs in certain medical units, subject to several safeguards, presented a low risk for fraud or abuse.
As noted by legal experts, this AO deviates from OIG’s typical approach to limiting arrangements involving potential remuneration from a hospital to its referring physicians. (Read more…)
Ark Investment Management’s chief executive Cathie Wood is upbeat about her strategy of investing in young technology companies. After her exchange-traded funds dropped 60% to 80% last year from highs in 2021, Woods talked about the current stock market environment in a year-end commentary Dec. 29, 2022.
“We’re getting a lot of deflationary signals, but the Fed isn’t buying in yet,” Wood said, referring to the Federal Reserve’s continuing interest-rate increases. “But the bond market will start to convince the Fed,” Wood said. “The bond market is telegraphing much lower-than-expected inflation and/or recession.”
That prediction seemed to be validated February 1st. when the Federal Open Market Committee (FOMC) raised interest rates by only 25 basis points. That was smaller than the 50 basis points it had raised them by in December and the 75 basis points it had increased the rates by in each of its previous four meetings. The Fed seemed to have been recognizing the deflationary signs.
***
Markets: In the five weeks of trading so far in 2023, the NASDAQ gained in all five and the S&P 500 in four. The still-booming labor market and falling inflation appear to be outweighing poor corporate earnings in investors’ minds.
Stocks ended the week subdued when a red-hot jobs report once again got investors biting their nails over what the Fed will do next—though the S&P and NASDAQ both eked out positive weeks. The tech stock rally started losing steam after several big companies reported disappointing quarterly results, with Amazon being the one investors cooled on most.
More specifically, racing game publisher Motorsport Games (NASDAQ:MSGM) is seeing more volatility, tumbling 24.2% Friday after announcing a $4M at-the-market offering. The company entered a definitive agreement to issue and sell 232,188 shares of its class A common stock at $17.39 per share. The stock has slid $5.46 to trade at $17.50. The closing of this new offering is set for on or around February 7th with H.C. Wainwright & Co. acting as exclusive placement agent. Gross proceeds will be about $4.03M, which Motorsport Games will put toward development of multiple games, working capital and general purposes.
Still, it was the most eventful week for the stock in many months. On Monday it launched a debt-for-equity exchange to shore up its balance sheet, sending the stock lower by 8.7%. After regaining full compliance with Nasdaq listing rules, the stock jumped 714% Tuesday, moving from $2.63 a share to $21.40. After moving up another 73% Wednesday, the company then moved to convert all remaining debt in a new debt-for-equity exchange, and the stock fell 38% Thursday. Before Friday’s decline, the stock moved up an aggregate 482% in five days.
Not even the healthcare industry is recession-proof
By Staff Reporters
***
***
According to Kristine White of Healthcare Brew, New York City-based Memorial Sloan Kettering Cancer Center (MSK), one of the country’s top cancer treatment facilities, laid off 337 employees on Jan. 17 in response to ongoing financial challenges, according to a New York State Department of Labor filing.
The 337 employees, who worked across 14 sites and in multiple departments, represent about 1.5% of MSK’s 22,500 employees. This is a slight decrease from the expected 3% of layoffs announced in November 2022.
“This reduction was necessary to ensure that MSK can continue to invest in the future of cancer care, research, and education for the benefit of generations to come, and every effort has been made to ensure that patient care is not impacted,” spokesperson John Connolly said in a statement shared with Healthcare Brew.
The institution’s operating losses totaled $116.1 million for Q3 of 2022, compared to a loss of $8.7 million during the same period in 2021, according to a quarterly financial report released in November last year.
Factors such as increased patient activity, wages, and supply costs from inflation pushed the system’s operating expenses up by 7.5% from Q3 of 2021 to Q3 of 2022. The cancer center hired more staff in 2022 with the expectation that patient volume would increase, according to the financial report.
Health systems like MSK often reevaluate their biggest expense (workers) when business is down, Lori Kalic, a healthcare senior analyst at consulting firm RSM, told Healthcare Brew.
Just this year, multiple hospitals and health systems have also announced layoffs, including Tufts Medicine in Boston and Integris Health in Oklahoma, according to White.
Treasury yields jumped after a much stronger-than-expected U.S. January jobs report clouded investor expectations for the Federal Reserve to end its interest rate hiking cycle in coming months. Treasury Yields and debt prices move opposite each other:
The yield on the 2-year Treasury note rose 14.9 basis points to 4.233%.
The 10-year Treasury note yield jumped 9.9 basis points to 3.498%.
The 30-year Treasury bond yield was up 6.9 basis points at 3.626%.
***
U.S. equities declined in a choppy trading session following a stronger-than-expected January labor report, and some uninspiring earnings results from mega-cap stocks. Non farm payroll additions beat estimates by a large amount, and the unemployment rate declined, solidifying the notion of a tight job market.
Meanwhile, a read on domestic services sector activity moved back into expansion territory. Mega-cap stocks were in focus today, as Dow member Apple missed estimates and posted its first quarterly decline in revenues since 2019, and Alphabet also posted discouraging quarterly results, while Qualcomm bested EPS estimates by a penny, but fell short on the revenue side.
Notably, the retail giant Amazon is finally starting to feel the economic pinch. The e-commerce company, which most people thought was unstoppable, has reportedly had its first unprofitable year since 2014. The company released this week that it has lost over $2 billion in 2022, despite holiday-season sales increasing by 9%.
Asian and European stocks finished mixed, as the markets continued to process the week’s monetary policy decisions, as well as some services sector data across the globe.
***
Elon Musk was found not liable for investors’ losses in a securities fraud trial over his 2018 tweet that he had “funding secured” to take Tesla private at $420 per share, continuing the tech mogul’s streak of favorable verdicts over his erratic behavior. Plaintiff Glen Littleton and fellow members of the class action sued Musk and Tesla, including its board of directors, over the tweet and Musk’s subsequent statements, alleging the notion that financing was in place had been false. They said shareholders suffered steep financial harms because of panicked sales in the 10 days following the tweet, as Tesla and Musk engaged in damage control.
While financial planning rules of thumbs are useful to people as general guidelines, they may be too oversimplified in many situations, leading to underestimating or overestimating an individual’s needs. This may be especially true for physicians and many medical professionals. Rules of thumb do not account for specific circumstances or factors occurring at a particular time, or that could change over time, which should be considered for making sound financial decisions.
For example, in a tight job market, an emergency fund amounting to six months of household expenses does not consider the possibility of extended unemployment. I’ve always suggested 2-3 years for doctors. Venture capitalist lay-offs of physicians during the pandemic confirm this often criticized benchmark opinion of mine.
As another example, buying life insurance based on a multiple of income does not account for the specific needs of the surviving family, which include a mortgage, the need for college funding and an extended survivor income for a non-working spouse. Again a huge home mortgage, or several children or dependents, may be the financial bane of physician colleaguesand life insurance.
A home purchase should cost less than an amount equal to two and a half years of your annual income. I think physicians in practice for 3-5 years might go up to 3.5X annual income; ceteras paribus.
Save at least 10-15% of your take-home income for retirement. Seek to save 20% or more.
Have at least five times your gross salary in life insurance death benefit. Consider 10X this amount in term insurance if young, and/or with several children or other special circumstances.
Pay off your highest-interest credit cards first. Agreed.
The stock market has a long-term average return of 10%. Agreed, but appreciated risk adjusted rates of return..
You should have an emergency fund equal to six months’ worth of household expenses. Doctors should seek 2-3 years.
Your age represents the percentage of bonds you should have in your portfolio. Risk tolerance and assets may be more vital.
Your age subtracted from 100 represents the percentage of stocks you should have in your portfolio. Risk tolerance and assets may still be more vital.
A balanced portfolio is 60% stocks, 40% bonds. With historic low interest rates, cash may be a more flexible alternative than bonds; also avoid most bond mutual funds as they usually never mature.
There are also rules of thumb for determining how much net worth you will need to retire comfortably at a normal retirement age. Here is the calculation that Investopedia uses to determine your net worth:
If you are employed and earning income: ((your age) x (annual household income)) / 10.
If you are not earning income or you are a student: ((your age – 27) x (annual household income)) / 10.
US employers in January announced the most job cuts since 2020, according to data compiled by Challenger, Gray & Christmas, Inc. Businesses reported 102,943 cuts in the month, more than twice those announced in December and up 440% from January 2022. The technology sector made up 41% of the planned reductions. Announced layoffs at retailers and financial companies also climbed from a year ago.
Meanwhile, U.S. stocks ended the day mixed, with the S&P 500 and NASDAQ adding to yesterday’s rally that came as the Fed hiked rates by a decelerated amount and suggested that it may be nearing the end of its tightening cycle. The global markets also reacted to 50-basis point rate increases from the European Central Bank and Bank of England.
Earnings continued to pour in, with Meta Platform jumping after some upbeat guidance, and Eli Lilly and Company saw pressure after some softer-than-expected revenue growth. The economic calendar delivered some positive news, with Q4 productivity much stronger than expected and unit labor costs slowing more than anticipated, and jobless claims continued to slide, while factory orders missed estimates.
Treasury yields were unchanged, and the U.S. dollar gained ground, while crude oil and gold prices declined. Asian stocks finished mixed following the Fed’s decision, and markets in Europe were mostly higher in the wake of the monetary policy decisions in the region.
***
***
Finally, a Japanese maker of flying motorbikes will list on the NASDAQ stock exchange and start trading in New York, making it the fifth company from the Asian nation to join the tech-heavy bourse, according to Bloomberg. Tokyo-based ALI Technologies Inc. is going public through a merger with the blank-check firm Pono Capital Corp. Under terms of the deal, ALI Technologies will become a fully owned unit of its US arm, Aerwins Technologies, the people said, asking not to be named because the information isn’t yet public. Its market cap is expected to be at least $600 million, in line with its target last year despite a market selloff. Its ticker will be AWIN.
According to Bloomberg, applications for US unemployment benefits fell for the fourth time in five weeks, underscoring the broad resilience of the job market that threatens to keep inflation elevated. Initial unemployment claims ticked down by 3,000 to 183,000 in the week ended January 28th, the lowest since April, Labor Department data showed Thursday. The median forecast in a Bloomberg survey of economists called for 195,000 applications.
Continuing claims, which include people who have already received unemployment benefits for a week or more, fell to 1.66 million in the week ended January 21st. The labor market, while cooling at the margins, is still tight by many measures and remains one of the key hurdles in the Federal Reserve’s fight against inflation. Even though payrolls growth has slowed and companies in technology and banking have laid off staff in recent months, demand for workers still far exceeds supply, which could put upward pressure on wages and broader prices.
In this episode, we talk about the importance of building a personal brand, regardless of whether you own your own practice or are employed. We touch on why this is important, what are the most common mistakes doctors make when doing it and how to get started.
Due to a lack of demand for chips and a slowdown in its data processing center business, Intel just reported its worst financial results since the dot-com bubble popped at the turn of the century. Though the stock only ended up falling 6.4% by the time the market closed yesterday, Wall Street definitely took notice of the company’s troubles.
And so, twenty-one analysts slashed what they thought it was worth, and many did not hold back in describing the chip maker’s fall. “No words can portray or explain the historic collapse of Intel,” one said according to Bloomberg.
***
Samsung Electronics Co., however, made a surprisingly aggressive decision to keep capital spending at the same level as last year, defying expectations it would go along with rivals in pulling back to alleviate pressure on an already-battered semiconductor industry. The result will be more pressure on chip pricing than if the Korean giant had pulled back spending on new machinery and factory capacity.
President Biden plans to end both the public health and national emergencies originally declared to address the Covid pandemic in 2020 (and extended several times since) on May 11th 2023.
The White House just disclosed the plan while opposing efforts by Republican lawmakers to end the emergency declarations immediately with a bill called the Pandemic Is Over Act. The end of the emergencies will mean that many Americans will have to start paying for COVID tests, treatments, and vaccines.
It also signals a shift in how serious the government considers the pandemic to be. But, is this wise?
Whether we’ve got a recession coming remains the biggest will they or won’t they story, but it looks like more Americans are starting to sock away cash just in case.
Data just released by the Department of Commerce puts the savings rate for December at 3.4%—the highest level in seven months and the biggest uptick from the previous month since July 2021 (November’s rate was 2.9%).
Serta Simmons Bedding, the Georgia-based mattress maker owned by private equity firm Advent International, has filed for Chapter 11 bankruptcy protection. The prepackaged bankruptcy filing includes $125 million of debtor-in-possession financing and another $125 million once it exits Chapter 11.
***
U.S. equities finished mixed in a lackluster trading session, as Q4 earnings season shifted into a higher gear today. Corporate results from several Dow members were in focus, as 3M missed estimates and reported that it would reduce its global workforce by approximately 2,500 jobs. Verizon Communications and Travelers Companies reported bottom-line results that were in line with expectations, and the former offered some disappointing full-year guidance, while Johnson & Johnson missed estimates amid a decline in revenues citing unfavorable foreign exchange and lower COVID vaccine sales.
Additionally, Lockheed Martin bested forecasts but issued EPS guidance that was lower than anticipated. The economic calendar offered several reports on domestic activity, as manufacturing and services PMIs unexpectedly rose but remained contractionary in January, while manufacturing activity in the Richmond region fell much more than expected.
Treasury rates were lower, and the U.S. dollar dipped, while crude oil prices fell, and gold was higher.
Asian stocks rose although volume remained light as Chinese and South Korean markets were closed for a holiday, while European stocks were mixed amid a host of PMI data across the globe.
Lunar New Year is the beginning of a lunar calendar or lunisolar calendar year, whose months are moon cycles. The event is celebrated by numerous cultures in different ways and at different dates.
It is also celebrated by other cultures, such as the Nisga’a people of Canada. The determination of the first day of a new lunar year varies by culture.
The United States Congress designated January as Cervical Health Awareness Month. More than 14,000 women in the United States are diagnosed with invasive cervical cancer each year, but the disease is preventable with vaccination and appropriate screening.
During January, NCCC and its many local chapters across the country highlight issues related to cervical cancer, HPV disease and the importance of early detection. While NCCC chapters host events throughout the year, January is a month with a special focus as chapters celebrate Cervical Health Awareness Month and work to spread the word in their communities.
NCCC and the American Sexual Health Association (ASHA) also offer a range of resources (listed below) to educate the public and healthcare providers about cervical health, from fact sheets to episodes of ASHA’s Sex+Health podcast.
As you likely know, the US spends muchon healthcare ($4.3 trillion in 2021, to be exact). But did you also know that healthcare fraud makes up a not-so-small piece of that pie?
The National Health Care Anti-Fraud Association (NHCAA), a national organization that works to prevent health insurance fraud, conservatively estimates that 3% of the US’s total annual healthcare spend—a hearty $129 billion—is lost to healthcare fraud. Some government agencies estimate that percentage to be as high as 10% (that’s $430 billion), according to the NHCAA.
Overall, Medicare fraud costs the US about $60 billion each year, Nicole Liebau, national resource center director for Senior Medicare Patrol, a government-funded organization designed to help prevent Medicare fraud, told Healthcare Brew, though she added that “the exact figure is impossible to measure.”
While Medicare fraud isn’t new, the US saw a rise in one particular tactic during the pandemic: a durable medical equipment (DME) scheme.
How the schemes work.
In a DME scheme, scammers target Medicare patients—often after a procedure or an injury—and cold-call them to offer free equipment, said Jennifer Stewart, senior associate general counsel and senior director of fraud prevention and investigation at Blue Cross Blue Shield of Massachusetts. The scammers offer consumers items like lidocaine, wheelchairs, walkers, or braces.
The scammers have roped in doctors—who are often unaware they’re working with scammers instead of legitimate medical companies—to sign off on prescriptions that are then used to bill Medicare for the equipment, Stewart said. Sometimes patients actually receive the products, and sometimes they don’t.
“It’s really dangerous because [a prescription like lidocaine] could have reactions with other medications. The durable medical equipment isn’t sized for them, and certainly the doctor who treated their injury didn’t prescribe it […] There is a lot of patient harm involved,” Stewart said. Keep reading here.
Turnitin (stylized as turnitin) is an Internet-based plagiarism detection service run by the American company Turnitin, LLC, a subsidiary of Advance Publications.
Founded in 1998, it sells its licenses to universities and high schools who then use the software as a service (SaaS) website to check submitted documents against its database and the content of other websites with the aim of identifying plagiarism. Results can identify similarities with existing sources and can also be used in formative assessment to help students learn to avoid plagiarism and improve their writing.
Students may be required to submit work to Turnitin as a requirement of taking a certain course or class. The software has been a source of controversy, with some students refusing to submit, arguing that requiring submission implies a presumption of guilt. Some critics have alleged that use of this proprietary software violates educational privacy as well as international intellectual-property laws, and exploits students’ works for commercial purposes by permanently storing them in Turnitin’s privately held database.
Turnitin, LLC also runs the informational website plagiarism.org and offers a similar plagiarism-detection service for newspaper editors and book and magazine publishers called iThenticate. Other tools included with the Turnitin suite are GradeMark (online grading and corrective feedback) and PeerMark (student peer-review service).
NOTE: According to Wikipedia, in March 2019, Advance Publications acquired private Turnitin, LLC for US$1.75 billion.
The U.S. Financial Markets will be closed today, Monday January 16th 2023, for Martin Luther King, Jr. Day.
***
This federal holiday was first observed in 1986. In 1994, Congress passed the King Holiday and Service Act, designating the Martin Luther King Jr. Federal Holiday as a national day of service and charged the Corporation for National and Community Service with leading this effort.
***
House Oversight Committee Chairman James Comer just said he hoped a U.S. debt default could be avoided. A default would greatly impact the economy and people in the U.S: A default would increase interest rates, which would then increase prices and contribute to inflation. The stock market would also suffer, as U.S. investments would not be seen as safe as they once were, especially if the U.S. credit rating was downgraded. Fortunately, the U.S. has never reached the point of default where the Treasury was incapable of paying U.S. debt obligations, though it has been close on several occasions. The only exception was during the War of 1812 when parts of Washington D.C. including the Treasury were burned.
A judge just ruled that a group of laid-off Twitter employees suing the business over their severance compensation, have to pursue their claims individually rather than as part of a class action, according to a Bloomberg report. About 500 of the roughly 3,700 Twitter employees Elon Musk laid off since taking control of the company last year have already filed individual arbitration claims, according to Shannon Liss-Riordan, the lawyer who filed those claims on the workers’ behalf.
***
SPAC SEEKING SPAC: Money-losing companies that recently went public via SPAC are combining with other SPACs to secure more funding and stay afloat. The ultimate goal is one giant SPAC?
Triskaidekaphobia (/ˌtrɪskaɪˌdɛkəˈfoʊbiə/ TRIS-kye-DEK-ə-FOH-bee-ə, TRIS-kə-; from Ancient Greek τρεισκαίδεκα (treiskaídeka) ‘thirteen’, and Ancient Greek φόβος (phóbos) ‘fear’) is fear or avoidance of the number 13.
It is also a reason for the fear of Friday the 13th, called paraskevidekatriaphobia (from Greek Παρασκευή (Paraskevi) ‘Friday’, Greek δεκατρείς (dekatreís) ‘thirteen’, and Ancient Greek φόβος (phóbos) ‘fear’) or friggatriskaidekaphobia (from Old Norse Frigg ‘Frigg’, Ancient Greek τρεισκαίδεκα (treiskaídeka) ‘thirteen’, and Ancient Greek φόβος (phóbos) ‘fear’).
Swarm learning, or swarm intelligence, is how swarms of bees or birds move in response to their environment.
When applied to data there is “more peer-to-peer communications, more peer-to-peer collaboration, more peer-to-peer learning and that’s the reason why swarm learning will become more and more important as … as the center of gravity shifts” from centralized to decentralized data.
Medicine Example:
Consider this example, “A hospital trains their machine learning models on chest X-rays and sees a lot of tuberculosis cases, but very little of lung collapsed cases. So therefore, this neural network model, when trained, will be very sensitive to what’s detecting tuberculosis and less sensitive towards detecting lung collapse.”
“However, we get the converse of it in another hospital. So what you really want is to have these two hospitals combine their data so that the resulting neural network model can predict both situations better. But since you can’t share that data, swarm learning comes in to help reduce that bias of both the hospitals.”
And this means, “each hospital is able to predict outcomes, with accuracy and with reduced bias, as though you have collected all the patient data globally in one place and learned from it.”
Moreover, it’s not just hospital and patient data that must be kept secure. What swarm learning does is to try to avoid or reduce the sharing of data, or totally prevent the sharing of data, to [a model] where you only share the insights, or you share the learnings.
In a recent survey by Edelman Financial Engines, 57% of respondents said they’d feel wealthy if they had $1 million in the bank. But for many people, that’s not enough.
Among those with $500,000 and $3 million in assets, 53% said it would take over $3 million in the bank for them to feel wealthy, and 33% said it would take over $5 million. Given that these are amounts some people will never even come close to amassing in their lifetimes, it may be hard to wrap your head around these answers.
Consumer price data will offer clues about the Federal Reserve’s next policy move, while quarterly results from big banks get fourth quarter earnings season underway.
The stock market rally to kick off 2023 will be put to the test next week when investors face a highly-awaited inflation reading and the start of fourth quarter earnings season, which will be led by big banks.
And, this Thursday morning will bring December’s Consumer Price Index (CPI), a release likely to dictate bets on whether the Federal Reserve raises interest rates by 0.25% or 0.50% at the start of next month.
According to Yahoo Funance, economists expect headline CPI rose 6.6% over the prior year in December, a downshift from the 7.1% increase seen in November, according to data from Bloomberg. On a month-over-month basis, CPI likely stayed flat.
Core CPI, which removes the volatile food and energy components of the report and is closely tracked by the Fed, is also expected to have risen at a slower pace last month, coming in at 5.7% after a 6% increase in November. Over the prior month, core CPI is expected to rise 0.3% after a 0.2% jump in November.
Policymakers monitor “core” inflation more closely due to its nuanced look at key inputs like housing, while the headline CPI figure has moved largely in tandem with volatile energy prices this year.
Dry January is a campaign delivered by Alcohol Change UK where people sign up to abstain from alcohol for the month of January. The term “Dry January” is a registered trademark with Alcohol Change UK and was first registered in 2014.
The campaign was first delivered in 2013 by Alcohol Concern (now called Alcohol Change UK) and 2023 marks the 10th anniversary of the campaign. Emily Robinson, founded the campaign after taking a month off alcohol in January 2011 to prepare for a half marathon. After noticing the benefits and people’s interest in her month off alcohol she decided to start the campaign when she joined Alcohol Concern in 2012. Around the same time Nicole Brodeur of The Seattle Times wrote a column on her first Dry January motivated by a friend who had done the same for several years before.
In its first year, 4,000 people signed up for Dry January and it has grown in popularity ever since with over 130,000 people signing up to take part in 2022. Dry January was endorsed by Public Health England in 2015 leading to a large uptake in numbers and steady increase in participants year on year. Research by the University of Sussex published in 2020 found that those signing up to take part in Dry January using Alcohol Change UK’s free Try Dry app and/or coaching emails were twice as likely to have a completely alcohol-free month, compared to those who try to avoid alcohol on their own in January, and have significantly improved well-being and healthier drinking six months later.
A multi-disciplinary panel of doctors and IT experts from Asia, the United States, and Europe analyzed published articles regarding expert consensus on the Medical Internet of Things, with reference to study results in the field of metaverse technology.
Silvergate Capital Corporation reported a sharp drop in fourth-quarter crypto-related deposits on Thursday as investors spooked by the collapse of FTX pulled out more than $8 billion in deposits, sending shares down more than 42%. The crypto-focused bank also said it would cut its workforce by 40%, or about 200 employees, as it tries to rein in costs amid a deepening industry downturn. Its stock was last trading at $12.55.
***
U.S. stocks were lower as the markets continued to speculate as to how long the Fed will keep its monetary policy tight. Yesterday’s minutes from the Fed’s December meeting suggested that the Central Bank will remain aggressive. Jobs data pointed to a tight labor market, as the ADP Employment Change Report came in higher than expected, and jobless claims were lower than anticipated, which seemed to be solidifying expectations of further rate hikes. Services sector data also came out, with output being revised higher but continuing to depict contraction.
Treasury yields were mixed, and the U.S. dollar rallied following the data, while crude oil prices rose, and gold dropped.
Equity news offered varying results, as Exxon Mobil offered mixed Q4 guidance, T-Mobile US’ phone customers topped forecasts, Constellation Brands missed earnings estimates and lowered guidance, and Conagra Brands topped quarterly estimates.
Finally, Asian stocks finished mostly higher, and European stocks were mixed following a three-day winning streak, as the markets digested the Fed’s minutes and amid optimism regarding China’s reopening.
Stocks are coming off their worst year since 2008 due to investors misjudging how high inflation would soar and the lengths central banks would go to bring it back down.
For example, Global equities lost a record $18 trillion in 2022 amid nearly 300 interest rate hikes from central banks around the world.
But not all stocks were clobbered equally by Jerome Powell and Co.: High-growth tech companies that got a boost from an era of low interest rates got rocked the most in what some are calling the sequel to the bursting of the dot-com bubble in 2000–01. The tech-heavy NASDAQ posted four straight negative quarters for the first time since that crash.
Others survived unscathed. The energy sector soared 59% last year thanks to a boost from surging oil prices. Exxon Mobil finished the year as the eighth-most valuable public company in the US, despite starting 2022 outside the top 25.
The Future?
No one really knows, but analysts generally think stocks will go sideways, weighed down by more rate hikes and a potential recession. The average Bloomberg projection for the S&P at the end of 2023 is 4,009 points (the index closed 2022 at 3,839.50).
Another down year would be extremely rare: The S&P has dropped for two consecutive years in just four instances since 1928.
The Fed hikes interest rates, sending economy teetering toward a recession?
If everyone was an opinionated virologist in 2020, then 2022 turned us all into macro-economists. In an effort to fight historic inflation, the Fed raised its benchmark interest rate seven times this year, pushing it to a 15-year high. Chair Jerome Powell’s hawkish turn slowed the economy and was a major catalyst for the brutal sell-off in stocks, particularly in the tech sector. This year, Amazon became the first public company to lose $1 trillion in market value.
The U.S. housing market is experiencing its second-biggest home price correction of the post-World War II era. Macro Trends Advisors founding partner Mitch Roschelle attributed the massive correction to Americans’ uncertainty for the markets and their “uneasiness” regarding the economy. He explained on “Varney & Co.” that the “shoe to drop” would be if the nation starts to see a rise in unemployment, which could cause a “leg down” in the housing market.
Finis?
So what’s ahead for 2023? According to MorningBrew, Economists think that a recession is likely, but a few are holding out hope that the Fed can achieve a so-called “soft landing,” where it brings inflation down to normal levels without causing the economy to shrink. Recent months have brought cautiously hopeful news: Annual inflation has cooled from a peak of 9.1% to 7.1%, so rate hikes are expected to be much less aggressive next year.
Tesla CEO Elon Musk’s net worth has shrunk by an astounding $140 billion, slashing his wealth to $130 billion as of 2022, according to the Bloomberg Billionaires Index. The sharp decline reflects the roughly 70% drop in Tesla stock this year, driven by investors swapping technology stocks for safer assets, worrying that running Twitter is a costly distraction for Musk, and fearing a US economic downturn and overseas headwinds will hit the automaker’s growth.
Meanwhile, Amazon founder Jeff Bezos’ wealth has fallen by $86 billion, while Alphabet cofounders Larry Page and Sergey Brin have seen their fortunes shrink by a combined $91 billion. Microsoft cofounder Bill Gates’ net worth has also tumbled by $29 billion, while former CEO Steve Ballmer has taken a $21 billion hit.
Similarly, Oracle cofounder and Tesla investor Larry Ellison has suffered a $17 billion blow to his fortune, while Warren Buffett’s wealth has only dropped by $3 billion. The eight Americans, along with LVMH’s Bernard Arnault, Adani Group’s Gautam Adani, and Reliance Industries’ Mukesh Ambani, hold the top 11 spots in Bloomberg’s global wealth rankings.
Initial claims for state unemployment benefits rose 9,000 to a seasonally adjusted 225,000 for the week ending December 24th, the Labor Department reported, in line with the median estimate among economists polled by Reuters. Meanwhile, the number of people receiving benefits after an initial week of aid rose 41,000 to 1.710 million in the week ending December, 17th, 2022.
Meanwhile, Amazon stock closed the December 22 trading session at $83.79, which represents a 49.7% drop compared to December 31, 2021. This is the lowest closing level for the Amazon stock since March 12, 2019. Basically, the group, founded by Jeff Bezos, has completely erased all the gains during the two years when strict restrictions were put in place to limit the spread of COVID-19. It closed today at $84.18.
***
Finally, U.S. stocks rose sharply, ending a two-session losing streak, though trading volumes remain subdued in the final days of the year. The heavyweight Information Technology sector led the rally, rebounding from a recent drop that has weighed on the markets this week. The equity front continued to offer little in terms of headlines, though shares of Cal-Maine Foods fell after the company missed earnings estimates.
The economic calendar introduced labor data, as jobless claims ticked slightly higher compared to the prior week.
Treasury yields were mixed, the U.S. dollar dropped, crude oil prices were lower, and gold traded higher.
Asian stocks finished mostly lower after yesterday’s downturn in the U.S., while markets in Europe were higher despite uncertainty regarding the ultimate global impact of aggressive monetary policy tightening across the world.
DEFINITION: Affinity marketing is a concept that consists of a partnership between a company and an organization that gathers persons sharing the same interests to bring a greater consumer base to their service, product or opinion. This partnership is known as an affinity group.
So, after the collapse of Sam Bankman-Fried’s crypto exchange FTX, a number of celebs who had acted as ambassadors for the company were named as defendants in a class-action suit against it.
Comedian and Seinfeld creator Larry David, Tampa Bay Buccaneers quarterback Tom Brady, and basketball stars Shaquille O’Neal and Stephen Curry were likely trading lawyer recommendations in the A-lister group chat.
RALLY: A rally is a period of sustained increases in the prices of stocks, bonds or indices … An increase in prices during a primary trend bear market is called a bear market rally. A bear market rally is sometimes defined as an increase of 10% to 20%.
Now, a Santa Claus Rally describes a sustained increase in the stock market that occurs in the last week of December through the first two trading days in January. There are numerous explanations for the causes of a Santa Claus rally including tax considerations, a general feeling of optimism and happiness on Wall Street, and the investing of holiday bonuses.
Another theory is that some very large institutional investors, a number of which are more sophisticated and pessimistic, tend to go on vacation at this time, leaving the market to retail investors, who tend to be more bullish.
Since Christmas Day [Sunday], the U.S. stock markets were closed on Monday, December, 26th, 2022.
OPENTODAY!
***
Nevertheless, nearly 125,000 employees lost their jobs this year as more than 120 large U.S. tech companies, banks and manufacturers implemented massive rounds of layoffs, according to the Forbeslayoff tracker, which documented major cuts (over 100) beginning in June when recession fears began to surge.
That’s a troubling figure for what had been one of the economy’s strongest growth sectors, but economists don’t expect it to spell doom for other industries. Even as tech companies downsized, the broader labor market remained strong throughout the year, with the unemployment rate ticking up slightly, to just 3.7% as of November.
Happy Holidays from the Institute of Medical Business Advisors, Inc
At this special time of year, we give thanks for our clients and our employees, as well as all essential workers in hospitals, health centers and medical practices across the country.
May the holiday spirit be with you and your family throughout the season and everyday We look forward to serving you in 2023.
he emerging Omicron subvariant XBB contributes to an increasingly high number of COVID-19 cases in the U.S., rivaling the sister strains BQ.1.1 and BQ.1, according to the latest estimates from the Centers for Disease Control and Prevention (CDC).
Recent studies have indicated that the updated bivalent COVID-19 booster performed poorly against BQ.1.1, with even a weaker antibody response against XBB.
In late November, citing its poor neutralization effect on BQ.1 and BQ.1.1., the FDA pulled the emergency use authorization granted for bebtelovimab, a COVID-19 antibody therapy developed by Eli Lilly (LLY) and AbCellera Biologics (ABCL).
The CDC estimates for the week ending Dec. 24 show that XBB has made up ~18% of COVID cases in the U.S. compared to ~11% a week ago. Meanwhile, BQ.1.1 has led to ~36% of cases unchanged from a week ago, and BQ.1 caused ~27% of cases, a decline from ~29% last week.
Blue Cross Blue Shield has deployed several trackers on its website, according to the web extension Ghostery, a tool that can tell you what kind of technology web pages are using.
Ghostery returned a list of trackers from Twitter, Google, and LinkedIn.
Though we don’t know specifically what kind of data is being transferred, these pixels are usually installed to help marketing departments. Tracking pixels, for the uninitiated, are hidden or embedded graphics that can give a more complete picture of a customer’s journey: what they’ve clicked on, if they’ve searched for something specific, if they’ve put something in a shopping cart, or whether an advertisement drove them to, say, Blue Cross Blue Shield’s homepage. For example, if an insurer wants to show that its ads are working, it can use a pixel to determine that it was their ad that got someone to finally sign up for health insurance, not Susan in HR.
Trackers are ubiquitous, but experts and consumers have raised serious questions about the data that’s shared between companies. For example, investigative reporting outlet The Markup found that hospitals shared sensitive information with Facebook through the Meta pixel. And just this month, Indianapolis-based Community Health Network reported that pixels may have affected 1.5 million of its patients.
For more, read Marketing Brew’s interview with sociologist Mary F.E. Ebeling, who wrote a book about the collection of sensitive health data.
According to Wikipedia, the winter solstice, also called the hibernal solstice, occurs when either of Earth‘s poles reaches its maximum tilt away from the Sun. This happens twice yearly, once in each hemisphere (Northern and Southern). For that hemisphere, the winter solstice is the day with the shortest period of daylight and longest night of the year, when the Sun is at its lowest daily maximum elevation in the sky. Either pole experiences continuous darkness or twilight around its winter solstice. The opposite event is the summer solstice.
The winter solstice occurs during the hemisphere’s winter. In the Northern Hemisphere, this is the December solstice (usually 21st or 22nd December) and in the Southern Hemisphere, this is the June solstice (usually 20th or 21st of June). Although the winter solstice itself lasts only a moment, the term also refers to the day on which it occurs. The term midwinter is also used synonymously with the winter solstice, although it carries other meanings as well. Traditionally, in many temperate regions, the winter solstice is seen as the middle of winter; although today in some countries and calendars it is seen as the beginning of winter. Other names are the “extreme of winter” (Dongzhi), or the “shortest day”.
Since prehistory, the winter solstice has been a significant time of year in many cultures and has been marked by festivals and rituals. It marked the symbolic death and rebirth of the Sun; the gradual waning of daylight hours is reversed and begins to grow again. Some ancient monuments such as Newgrange, Stonehenge, and Cahokia Woodhenge are aligned with the sunrise or sunset on the winter solstice.
The Winter Solstice, or the December Solstice, is the point at which the path of the sun in the sky is farthest south. At the Winter Solstice, the sun travels the shortest path through the sky resulting in the day of the year with the least sunlight and therefore, the longest night.
Telehealth extension: Tucked in the new Congress’ spending bill is an extension of HHS rules that made telehealth more accessible during the pandemic. But the provision, which extends the flexibility through the end of 2024, falls far short of a push from some lawmakers who wanted to make that flexibility permanent.
Traditional guidance says not to spend more than 4% of your retirement savings in the first year to protect yourself from running out of money in your golden years. A new recommendation puts that figure at 3.8% with a 30-year time horizon, according to researchers at Morningstar Inc., a half-point higher than the 3.3% withdrawal they recommended in 2022 due to expectations for lower future investment returns. That means if you retire this year with a $640,000 portfolio invested 50% in stocks and 50% in bonds, you should take out no more than $24,320 in 2023.
U.S. equities finished higher in choppy action, posting the first gains in four sessions, as investors digested a host of monetary policy decisions from central banks in Asia. The Bank of Japan and People’s Bank of China kept their respective benchmark interest rates unchanged, but the former surprisingly tweaked its yield curve control policy.
Equity news was on the light side today, as General Mills beat earnings estimates and raised its full-year guidance, and shares of Steel Dynamics gained ground after it was announced that it would replace ABIOMED in the S&P 500.
On the economic front, housing starts declined less than anticipated, while building permits fell much more than expectations. Treasury yields rose, particularly on the long end of the curve, while the U.S. dollar fell, crude oil prices saw a modest increase, and gold prices rallied.
Asian stocks finished broadly lower and market in Europe diverged amid the host of monetary policy decisions.
Here’s what Covid vaccines have to do with auto insurance
A new study of 11 million adults in Canada revealed that people who weren’t vaccinated against Covid were 72% more likely to get into car accidents where at least one person had to go to the hospital.
Now, that doesn’t mean your jab protects against car accidents, of course, but it does suggest that folks who reject public health recommendations might also reject road rules. The difference was striking enough that the researchers said doctors should discuss road safety with unvaccinated patients, and that car insurance companies might want to factor it into their rates.
Laid off tech workers from Meta, Google and Twitter are being wooed by the federal government
Skilled tech workers laid off are in demand and the U.S. Department of Veterans Affairs wants to hire them.
The VA is looking to pay higher salaries than the agency had in the past and wants to make the hiring process easier. It’s banking on the mission of the agency to be a draw for talented tech workers.
Moreover, economic reports last week may have ushered in a new era for the stock market and some of these companies—one where investors are less concerned about inflation and more worried about an oncoming recession. Either way, there’s not a lot of hope on Wall Street right now and, barring a miracle, all three indexes will close out the year solidly in the red.
Finally, Tesla posted its worst week since March 2020 as investors increasingly call out Elon Musk for focusing his efforts on Twitter (but maybe that’s coming to an end…) In fact, Musk posted a poll asking users whether he should step down as the company’s chief executive (“I will abide by the results of this poll,” he said.) As of 5am ET, more than 57% voted “yes”—he should step down.
E-Mailing your Physician may Cost You like Your Attorneys!
***
WASHINGTON (AP) — The next time you message your doctor to ask about a pesky cough or an itchy rash, you may want to check your bank account first — you could get a bill for the question.
Hospital systems around the country are rolling out fees for some messages that patients send to physicians, who they say are spending an increasing amount of time poring over online queries, some so complex that they require the level of medical expertise normally dispensed during an office visit. Patient advocates, however, worry these new fees may deter people from reaching out to their doctor and that they add another layer of complexity to the U.S. health care system’s already opaque billing process.
“This is a barrier that denies access and will result in hesitancy or fear to communicate and potentially harm patients with lower quality of care and outcomes at a much higher cost,” said Cynthia Fisher, the founder of Patient Rights Advocate, a Massachusetts-based nonprofit that pushes for hospital price transparency.
The explosion of telehealth over the last three years — driven by the COVID-19 outbreak and relaxed federal regulations for online care — prompted many doctors to adopt more robust telecommunication with their patients. Consultations that once happened in an office were converted to computer or smart phone visits. And health care systems invited patients to use new online portals to message their doctors with a question at any time, American Medical Association president Jack Resneck Jr. told The Associated Press.
“When people figured out this is cool and could improve care, you saw hospitals and practice groups saying to patients, welcome to your portal … you can ping your physician with questions if you want,” Resneck said. “We found ourselves as physicians getting dozens and dozens of these a day and not having time built in to do that work.”
The charges vary for each patient and hospital system, with messages costing as little as $3 for Medicare patients to as much $160 for the uninsured. In some cases, the final bill depends on how much time the doctor spends responding.
[The Scream is a composition created by Norwegian artist Edvard Munch in 1893]
***
What [another] a week? U.S. equities declined, posting a second-straight weekly loss, as recession worries have ratcheted higher in the wake of a host of global central bank actions earlier this week. The Fed’s mid-week 50 basis point rate increase was followed by similar actions from the European Central Bank, the Bank of England, and Swiss National Bank. The moves came amid an evident slowdown in global economic growth, with data released today showing most manufacturing and services PMIs domestically and across the globe continue to see a contraction in activity, adding fuel to the recessionary fears.
RECESSION?
With U.S. stocks down more than 20% so far this year, investors are looking for some good news – and it may be coming from a prominent Wall Street analyst who says the current bear market could come to an end sometime around St. Patrick’s Day, 2023.
In an interview with Bloomberg Television, Mike Wilson, the Equity Strategist and Chief Investment Officer for Morgan Stanley predicted that the bear market in U.S. stocks could come to a conclusion early in 2023. Investors are taking note because Wilson, who’s typically skeptical about the market, is listed as No. 1 on Institutional Investor’s recent ranking of portfolio strategists.
WHEN?
“We think ultimately the bear market will be over probably sometime in the first quarter,” Wilson said on the broadcast.
***
Mutual Fund managers have taken their cash positions to the highest level in 21 years, according to the long-running monthly survey of portfolio managers. Relative to the history of the survey, investors are 2.6 standard deviations overweight cash and 3 standard deviations underweight equities.
A net 72% expect a weaker economy in the next 12 months, and 91% say earnings are unlikely to rise 10% of more in the next year. A growing percentage are expecting a policy pivot: 28% expect lower short-term rates in the next 12 months, up from 14% in September.
The survey “screams macro capitulation, investor capitulation, and crucially start of policy capitulation,” said Bank of America strategists led by Michael Hartnett. The S&P 500 has dropped 23% this year, and S&P’s U.S. government bond index has declined by 12%.
U.S. equities declined, posting a second-straight weekly loss, as recession worries have ratcheted higher in the wake of a host of global central bank actions earlier this week. The Fed’s mid-week 50 basis point rate increase was followed by similar actions from the European Central Bank, the Bank of England, and Swiss National Bank. The moves came amid an evident slowdown in global economic growth, with data released today showing most manufacturing and services PMIs domestically and across the globe continue to see a contraction in activity, adding fuel to the recessionary fears.
Treasury yields diverged, and the U.S. dollar was little changed, while crude oil prices fell, and gold traded to the upside. The equity front was relatively quiet, but Adobe’s quarterly results beat the Street on the top line, and the company reaffirmed its guidance, while shares of Darden Restaurants fell despite posting better-than-expected earnings and an upbeat outlook.
Asian stocks were mixed and European stocks saw widespread losses, as the global markets continued to digest the flood of monetary policy decisions around the world.
U.S. equities did an about-face and finished lower following the monetary policy decision from the Fed. The Central Bank increased the target for its benchmark interest rate by 50 basis points (bps), which was widely expected and a moderation from the 75-bp hikes over the past four meetings. However, in his presser Chairman Powell reiterated that the Committee still had a ways to go to reach its goals.
Treasury yields finished little changed in choppy trading after the Fed’s announcement, and the U.S. dollar was lower, while crude oil prices gained ground and gold traded to the downside.
Equity news was on the lighter side, as Delta Air Lines increased its Q4 earnings outlook and offered upbeat long-term guidance, while Lennox International issued a 2023 forecast that missed estimates.
On the economic front, mortgage applications snapped a two-week losing streak, and import prices moderated more than expected.
Asia finished mostly higher following yesterday’s favorable U.S. inflation report, while markets in Europe diverged as investors awaited today’s Fed decision, which will be followed by tomorrow’s announcements from the European Central Bank and Bank of England.
U.S. equities were able to finish higher after coming off early solid gains in the wake of the Consumer Price Index (CPI). The November CPI report came in softer-than-expected and seemed to somewhat sooth concerns regarding how aggressive the Fed will remain in its rate hike campaign. This came ahead of tomorrow’s highly anticipated Fed monetary policy decision, with the markets expecting a 50-basis point increase to the target fed funds rate.
Treasury yields tumbled following the inflation data, and the U.S. dollar fell, while crude oil and gold prices were sharply higher. In other economic news, the NFIB Small Business Optimism Index unexpectedly rose.
Equity news was light, as Oracle beat earnings estimates despite the significant impact of the strengthening U.S. dollar, while Raytheon Technologies authorized a $6 billion share repurchase program. European stocks finished higher, getting a boost from the CPI report, while markets in Asia were mixed
***
The world’s biggest central banks will this week wrap up the most aggressive year for interest-rate hikes in four decades with their fight against inflation still not over even as their economies slow. The US Federal Reserve on is set to raise its key rate by 50 basis points to a range of 4% to 4.5%, the highest since 2007, and to signal more increases in early 2023.
A day later, the European Central Bank and the Bank of England are likely to follow with half-point moves. And higher borrowing costs are also in the cards in Switzerland, Norway, Mexico, Taiwan, Colombia and the Philippines.
***
Earlier in October, Kiyosaki mentioned that he is bullish on Bitcoin because state-sponsored pension funds are starting to invest in BTC. Kiyosaki has repeatedly cautioned that the U.S. is heading toward an economic collapse. He said in a tweet that amid a financial meltdown, investors could keep their capital intact by loading up on gold, silver, and Bitcoin. At the time of writing, Bitcoin was trading at $17,156, up about 1% in the last seven days. The apex crypto’s market cap stood at around $330 billion.