PHYSICIAN INVESTING: Understanding Risk and Return

By Dr. David Edward Marcinko; MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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Investment Risk and Return

One of the major concepts that most investors should be aware of is the relationship between the risk and the return of a financial asset. It is common knowledge that there is a positive relationship between the risk and the expected return of a financial asset. In other words, when the risk of an asset increases, so does its expected return. What this means is that if an investor is taking on more risk, he/she is expected to be compensated for doing so with a higher return. Similarly, if the investor wants to boost the expected return of the investment, he/she needs to be prepared to take on more risk.

PORTFOLIO ALPHA: https://medicalexecutivepost.com/2025/07/02/managing-for-endowment-portfolio-alpha/

Harry Max Markowitz (August 24, 1927 – June 22, 2023) was an American economist who was a professor of finance at the Rady School of Management at UCSD. He is best known for his pioneering work in modern portfolio theory, studying the effects of asset risk, return, correlation and diversification on probable investment portfolio returns.

One important thing to understand about Modern Portfolio Theory (MPT) is Markowitz’s calculations treat volatility and risk as the same thing. In layman’s terms, Dr. Markowitz uses risk as a measurement of the likelihood that an investment will go up and down in value – and how often and by how much. The theory assumes that investors prefer to minimize risk. The theory assumes that given the choice of two portfolios with equal returns, investors will choose the one with the least risk. If investors take on additional risk, they will expect to be compensated with additional return.

MARKOWITZ: https://medicalexecutivepost.com/2011/01/19/the-living-legacy-of-dr-harry-markowitz/

According to MPT, risk comes in two major categories:

  • Systematic risk – the possibility that the entire market and economy will show losses negatively affecting nearly every investment; also called market risk
  • Unsystematic risk – the possibility that an investment or a category of investments will decline in value without having a major impact upon the entire market.

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Diversification generally does not protect against systematic risk because a drop in the entire market and economy typically affects all investments. However, diversification is designed to decrease unsystematic risk. Since unsystematic risk is the possibility that one single thing will decline in value, having a portfolio invested in a variety of stocks, a variety of asset classes and a variety of sectors will lower the risk of losing much money when one investment type declines in value. Thus putting together assets with low correlations can reduce unsystematic risks.

DIVERSIFICATION: https://medicalexecutivepost.com/2024/08/13/the-negative-short-term-implications-of-diversification/

a.   Understanding the Risk

Although broad risks can be quickly summarized as “the failure to achieve spending and inflation-adjusted growth goals,” individual assets may face any number of other subsidiary risks:

  • Call risk – The risk, faced by a holder of a callable bond that a bond issuer will take advantage of the callable bond feature and redeem the issue prior to maturity. This means the bondholder will receive payment on the value of the bond and, in most cases, will be reinvesting in a less favorable environment (one with a lower interest rate)
  • Capital risk – The risk an investor faces that he or she may lose all or part of the principal amount invested.
  • Commodity risk – The threat that a change in the price of a production input will adversely impact a producer who uses that input.
  • Company risk – The risk that certain factors affecting a specific company may cause its stock to change in price in a different way from stocks as a whole.
  • Concentration risk – Probability of loss arising from heavily lopsided exposure to a particular group of counterparties
  • Counterparty risk – The risk that the other party to an agreement will default.
  • Credit risk – The risk of loss of principal or loss of a financial reward stemming from a borrower’s failure to repay a loan or otherwise meet a contractual obligation.
  • Currency risk – A form of risk that arises from the change in price of one currency against another.
  • Deflation risk – A general decline in prices, often caused by a reduction in the supply of money or credit.
  • Economic risk – the likelihood that an investment will be affected by macroeconomic conditions such as government regulation, exchange rates, or political stability.
  • Hedging risk – Making an investment to reduce the risk of adverse price movements in an asset.
  • Inflation risk – The uncertainty over the future real value (after inflation) of your investment.
  • Interest rate risk – Risk to the earnings or market value of a portfolio due to uncertain future interest rates.
  • Legal risk – risk from uncertainty due to legal actions or uncertainty in the applicability or interpretation of contracts, laws or regulations.
  • Liquidity risk – The risks stemming from the lack of marketability of an investment that cannot be bought or sold quickly enough to prevent or minimize a loss.

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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Why [Too Many] Physician Colleagues Don’t Get Rich?

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PODIATRIST: Types, Specialization and Salary

THE FOOT & ANKLE DOCTORS

By A.I.

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Podiatry offers a promising career with a balanced mix of specialization and income. By understanding the factors that influence salaries—such as location, experience, and practice type—a doctor can strategically enhance his/er earning potential. Staying informed about healthcare policies and market trends is crucial for maximizing income.

With an aging population and advancements in technology, the demand for podiatrists is expected to grow, making it a rewarding field both professionally and financially. Investing in specialized training and adapting to policy changes will help doctors remain competitive and successful in the evolving healthcare landscape.

MORE: https://medicalexecutivepost.com/2024/12/03/12-investing-mistakes-of-physicians/

Frequently Asked Questions

What is a podiatrist?

A podiatrist is a healthcare professional specialized in diagnosing and treating conditions related to the feet and ankles. Their responsibilities include performing surgeries, prescribing orthotics, and providing preventive care.

MORE: https://medicalexecutivepost.com/2024/03/20/is-a-podiatrist-a-physician/

What education is required to become a podiatrist?

To become a podiatrist, one must complete a Doctor of Podiatric Medicine (DPM) degree, which typically takes four years after earning a bachelor’s degree. Following this, a residency program lasting 2-3 years is required for practical training.

What factors influence the salary of a podiatrist?

Geographic location, level of experience, specialization, and type of practice significantly affect a podiatrist’s salary. Areas with a higher cost of living or demand for services usually offer higher salaries.

How does the salary of a podiatrist compare to other medical professions?

Podiatrists generally earn more than general practitioners but less than specialty surgeons. This disparity is due to differences in training length, specialization, and practice complexity among these professions.

Can the salary of a podiatrist increase over time?

Yes, a podiatrist’s salary can increase with additional experience, further specialization, and strategic practice location choices. Continuing education and staying updated on healthcare policies can also enhance earning potential.

What impact do healthcare policies have on podiatrist salaries?

Healthcare policies, including changes in insurance reimbursement rates and government health initiatives, can affect podiatrist salaries. Adapting to these policy shifts is crucial for maximizing earning potential in the field.

What are the future trends in podiatry salaries?

Future trends suggest potential salary growth due to increasing demand from an aging population, technological advancements, and geographic disparities in healthcare access. Keeping informed about these trends can help podiatrists plan their careers strategically.

MORE: https://medicalexecutivepost.com/2011/09/22/is-the-mutual-fund-company-invesco-dis-respecting-podiatrists/

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, hospitals, financial advisory firms, RIAs, or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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PARADOX of Financial Health

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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FINANCIAL HEALTH

Classic Definition: Research from Ernst-Young [Nikhil Lele and Yang Shim] uncovered a chasm between how consumer patients think they’re doing financially, and the actual state of their finances. Even more striking, their study suggested that improving consumers’ financial health will become one of the top imperatives in reframing consumer financial services.

Modern Circumstance: For example, the study asked consumers to rate their own financial health, and 83 percent rated themselves “good,” “very good” or “excellent.”  Now, contrast this figure with what is known about their actual situation:

  • 60 percent of Americans say they are financially stressed.
  • 56 percent of Americans have less than $10,000 saved for retirement.
  • 40 million American families have no retirement savings at all.
  • 40 percent of Americans are not prepared to meet a $400 short-term emergency.

Paradox Example: Fortunately, even though the vast majority of consumers rate themselves as financially healthy, the study found that most still want to improve. Importantly for health economists, the attractive 25-34 and 35-49 year-old age groups were most likely to be extremely or very interested in improving their financial and economic health.

Paradox Example: Massively affluent consumer patients are even more interested in improving this paradox than their mass market counterparts.

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Stocks & Commodities

By A.I.

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  • Stocks: President Trump said there’s a “50/50 chance” of a deal with the EU ahead of next week’s deadline. Investors decided they like those odds, and pushed the NASDAQ and S&P 500 to yet another new closing record high—in fact, the S&P 500 set a new record every day this week. Meanwhile, trade deal talks with Brazil have reportedly stalled.
  • Commodities: Oil fell to a three-week low today as Iran signaled a willingness to come to the negotiating table with European powers for nuclear talks.
  • Hopes of trade deals and less need for a safe haven investment pushed gold prices lower.

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Commodities, Stocks and Bonds

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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  • Stocks: Investors were pleased to hear about the trade deal with Japan yesterday and reports of an agreement with the EU coming soon kept the stock rally alive through market close. The S&P 500 notched its 12th new closing record this year, and the NASDAQ ended the day above 21,000 for the first time.
  • Bonds: Treasury yields rose a bit after an auction of 20-year notes was met with strong demand, indicating investor appetite for longer-term US debt.
  • Commodities: Oil inched higher while gold edged lower as investors hedge their bets in anticipation of more trade deals before the August 1st deadline.

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Individual Up and Down Stocks

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What’s up

  • Medpace isn’t a meme stock, but it still soared 54.67% yesterday. It was all thanks to a seriously impressive beat-and-raise earnings report for the clinical researcher.
  • It was also a great day for healthcare stocks: IQVIA climbed 17.92% after beating Wall Street forecasts last quarter.
  • DR Horton popped 17.02% after the homebuilder crushed Q3 earnings expectations.
  • It was also a great day for other homebuilders: Pultegroup rose 11.52% despite lower home closings last quarter, and management is optimistic that sales will bounce back next quarter.
  • Northrop Grumman gained 9.41% after a strong quarter, including an 18% increase in international sales for the defense contractor.

What’s down

  • Lockheed Martin dropped 10.81% after the legacy defense contractor revealed big losses in its classified aeronautics program.
  • It wasn’t that great a day for defense contractors in general: RTX fell 1.58% after the company cut its earnings guidance.
  • General Motors may have beaten earnings expectations last quarter and kept its fiscal forecast intact, but investors didn’t like to hear about the $1.1 billion in tariff costs. Shares of the automaker stumbled 8.12%
  • Coca-Cola lost 0.59% after strong European sales helped the soft drink titan beat earnings estimates, but shareholders weren’t happy about weakness everywhere else.
  • Equifax tumbled 8.18% thanks to disappointing guidance for the current quarter from the consumer credit company.

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The GENIUS Act

By A.I.

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The GENIUS Act is the law of the Land

President Trump signed the bill into law Friday, setting up a framework for regulating stablecoins—digital currency pegged to traditional assets—that are linked to the US dollar. It’s a big win for the crypto industry, and Trump said it was a “giant step to cement American dominance of global finance and crypto technology.”

The law could help push stablecoins into the mainstream, and major companies like Walmart and Amazon have been said to be considering launching their own, according to Morning Brew.

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Crypto-Currency and the Stock Markets

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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  • Markets: Stocks slid lower today even as a preliminary survey revealed that consumer sentiment hit its highest point since February, while inflation expectations fell to pre-tariff levels. The selloff deepened on reports that President Trump wants 15% to 20% tariffs against the EU, though the NASDAQ managed to eke out a win.
  • Crypto: Although bitcoin fell after the president signed the GENIUS Act into law, ether rose to its highest price in six months today, while enthusiasm for the new legislation pushed total crypto assets above $4 trillion.

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Can You Contribute to Both a Roth IRA & 401(k)?

By Staff Reporters, AI and the Linqto Team

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Yes, you can contribute to both a Roth IRA and a 401(k), provided you don’t exceed annual contribution limits for each account.

Determining whether to contribute to a Roth IRA, 401(k), or both can be an important step in planning for your retirement. Here are the key differences, including tax advantages, employer contributions, and investment options. 

Eligibility requirements are the first consideration when contributing to a Roth IRA and a 401(k). For Roth IRA contributions, your eligibility is determined by your income. Specifically, if your modified adjusted gross income (MAGI) exceeds certain thresholds, your ability to contribute to a Roth IRA may be reduced or eliminated. However, there are no income limits for contributing to a 401(k), making it accessible to anyone with earned income.

IRS rules do allow for contributions to both a Roth IRA and a 401(k), provided you adhere to the annual contribution limits for each account.

This means you can take advantage of the higher contribution limits of a 401(k) while also benefiting from the tax-free growth of a Roth IRA. This dual approach can be a strategy for maximizing your retirement savings. The advantages to contributing to both accounts present some key benefits, such as: 

  • Tax diversification in retirement, allowing for better management of taxable income. 
  • Potential reduction of overall tax burden. 
  • Maximization of savings potential by taking full advantage of the benefits each account offers.3

Balancing contributions between a Roth IRA and a 401(k) requires careful planning. You might start by contributing enough to your 401(k) to receive the full employer match, which is essentially free money, if your employer offers this. Once you’ve secured the match, consider maxing out your Roth IRA contributions, if you’re eligible.

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COMMODITIES and STOCKS

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Stocks: Markets started the day on a high note thanks to a fifth straight decline in weekly initial jobless claims and surprisingly strong monthly retail sales. The NASDAQ hit its 10th record closing high of 2025 and the S&P 500 hit its ninth high.

Commodities: Lithium prices popped around the globe after the Chinese government ordered domestic producer Zangge Mining to halt operations. Plus, the US is reportedly set to impose 93.5% tariffs on Chinese imports of graphite, a key component.

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INCENTIVE STOCK OPTIONS: Defined

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Staff Reporters and AI

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Incentive stock options (ISOs)

Also called “qualified” or “statutory” stock options, ISOs are considered tax-advantaged stock options based on U.S. tax law. With ISOs, the spread (the difference between the award price and the fair market value) will count as income for the alternative minimum tax (AMT) in the year you exercise your options.

CBOE: https://medicalexecutivepost.com/2024/11/19/cboe-chicago-board-of-trade-volatility-indexes/

Example: If you exercise and hold the shares for more than one year past the exercise date and more than two years past the original grant date, the sale of the stock becomes a qualifying disposition, and any realized profit is typically taxed at the long-term capital gains rate. If you sell earlier, the spread will be taxed at your ordinary income tax rate.

ISOs vs. NSOs: What’s the difference?

There are two types of employee stock options: statutory and nonstatutory. They can also be referred to as qualified and nonqualified, respectively. ISOs are statutory (qualified) and differ from nonstatutory (nonqualified) stock options (NSOs) in a few key ways:

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  • Eligibility. ISOs are issued only to employees, whereas NSOs can be granted to outside service providers like advisors, board directors or other consultants. Typically, mainly senior executives or key employees are given ISOs, as a company is not required to offer ISOs to all employees.
  • Tax perks. ISOs have more compelling tax treatment compared with NSOs.

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EDUCATION: Books

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BETTORS & GAMBLERS: Taxation Update

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Staff Reporters

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What’s Different?

Bettors are currently able to deduct 100% of their gambling losses, so they only pay taxes on their winnings. But starting next year, only 90% of gambling losses will be deductible.

So, if a professional gambler wins $100,000, then loses $100,000 that same year, according to the New York Times:

  • In 2025, that gambler would owe taxes on $0.
  • In 2026, that gambler would owe taxes on $10,000.

Bettors could even end up paying taxes if they finished the year with a net loss.

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Psychiatrist V. Psychologist V. Psychotherapist

DEFINITIONS
By A. I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

PSYCHIATRIST

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

PSYCHOLOGIST

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

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

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Bitcoin, Stocks, Oil, Gold and Silver

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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Goldman Sachs and Bitcoin

SPONSOR: http://www.CertifiedMedicalPlanner.org

By A.I.

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

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

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Stocks, Commodities and Crypto-Currency

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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What is a “Market-Neutral” Fund?

Market Neutral Funds Demystified

[A Special Report]

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

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Introduction

SPONSOR: https://marcinkoassociates.com/

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

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

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

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

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

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

Definition of Market-Neutral

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

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

Here’s how it might work

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

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

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

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

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

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

Brief Description of Strategies

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

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

[A] Convertible Arbitrage

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

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

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

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

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

[B] Fixed-Income Arbitrage

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

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

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

[C] Equity Market-Neutral Arbitrage

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

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

Sounds easy, right?

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

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

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

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

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

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

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

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

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

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

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

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

[E] Event-Driven Arbitrage

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

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

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

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

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

Risk and Reward Characteristics

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

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

 

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

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

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

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

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

 

Asset Class/Strategy S&P500 MSCI World GovBonds CorpBonds

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

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

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

  

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

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

  

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

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

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

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

·  US Treasuries (Salomon Treasury Index 10yrs+)

·  High Grade Corporate Bonds  (Salomon Investment Grade Index)

·  Speculative Grade Corporate Bonds  (High Yield Index)

·  US Blue chip equities  (Dow Jones Industrial Average)

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

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

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

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

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

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

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

How to invest

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

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

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

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

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

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

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

[A] Lockup Periods

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

[B] Managerial Risks

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

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

[C] Fees

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

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

[D] Transparency

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

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

[E] Taxation

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

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

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

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

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

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

APPENDIX:  

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

 

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Gerontologist V. Geriatrician?

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BRANDS & BRAND MANAGEMENT: Defined and Explored for Doctors and Advisors

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What Is a Marketing Brand

A brand is a name, term, design, symbol or any other feature that distinguishes one seller’s goods or service from those of other sellers. Brands are used in business, marketing and advertising for recognition and, importantly, to create and store value as brand equity for the object identified, to the benefit of the brand’s clients, patients, customers, its owners and shareholders. Brand names are sometimes distinguished from generic or store brands.

BRANDING: https://medicalexecutivepost.com/2023/02/02/podcast-personal-branding-for-doctors/

What is Brand Management?

Brand management, also known as Marketing, is responsible for the overall management of a brand. This includes everything from product or service development and marketing to advertising and public relations. All of these aspects work together to create a particular image or reputation for a brand. The goal of brand management is to create a robust and positive reputation for a brand that will result in increased sales and market share.This process helps companies create a unique identity for their products or services in the marketplace. A successful brand management strategy can build client, patient and customer loyalty .

BRANDS: https://medicalexecutivepost.com/2021/06/03/physician-branding-post-pandemic/

Branding is essential for financial advisors, doctors and businesses because it involves creating a unique identity for a company’s products, offerings and services. It can also help build customer, client and patient loyalty and emotionally connect with the practitioner. Branding can be complex, but it is essential to understand the basics before starting a brand strategy.

Thus, doctors, podiatrists, dentists, CPAs, insurance agents, financial advisors and their practices need to understand the different aspects of branding and brand management to create a strong brand identity.

SELF BRANDING: https://medicalexecutivepost.com/wp-content/uploads/2011/03/leadership-self-branding-marcinko.pdf

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DOCTORS: Marketing, Advertising & Sales

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Stocks, Bonds and Safe Havens

By A.I.

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Financial Monte Carlo Simulation’s FLAW and FIXES

Physicians Must Understand Deus ex Machina

[By Wayne J. Firebaugh Jr; CPA, CFP®, CMP™]

SPONSOR: http://www.CertifiedMedicalPlanner.org

wayne-firebaughNamed after Monte Carlo, Monaco, which is famous for its games of chance, MCS is a software technique that randomly changes a variable over numerous iterations in order to simulate an outcome and develop a probability forecast of successfully achieving an outcome.

Endowment Fund Perspective

In private portfolio and fund endowment management, MCS is used to demonstrate the probability of “success” as defined by achieving the endowment’s asset growth and payout goals. In other words, MCS can provide the endowment manager with a comfort level that a given payout policy and asset allocation success will not deplete the real value of the endowment.

Divorce from Judgment

The problem with many quantitative software and other tools is the divorce of judgment from their use. Although useful, both mean variance optimization MVO and MCS have limitations that make it so they should not supplant the physician investor or endowment manager’s experience. MVO generates an efficient frontier by relying upon several inputs: expected return, expected volatility, and correlation coefficients. These variables are commonly input using historical measures as proxies for estimated future performance. This poses a variety of problems.

Problems with MCS 

First, the MVO will generally assume that returns are normally distributed and that this distribution is stationary. As such, asset classes with high historical returns are assumed to have high future returns.

Second, an MVO optimizer is not generally time sensitive. In other words, the optimizer may ignore current environmental conditions that would cause a secular shift in a given asset class returns.

Finally, an MVO optimizer may be subject to selection bias for certain asset classes. For example, private equity firms that fail will no longer report results and will be eliminated from the index used to provide the optimizer’s historical data [1].

Example:

As an example, David Loeper, CEO of Wealthcare Capital Management, made the following observation regarding optimization:

Take a small cap “bet” for our theoretical [endowment] with an S&P 500 investment policy. It is hard to imagine that someone in 1979, looking at a 9% small cap stock return premium and corresponding 14% higher standard deviation for the last twenty years, would forecast the relationship over the next twenty years to shift to small caps under-performing large caps by nearly 2% and their standard deviation being less than 2% higher than the 20-year standard deviation of large caps in 1979 [2].

Table: Compares the returns, standard deviations for large and small cap stocks for the 20-year periods ended in 1979 and 1999.  Twenty Year Risk & Return Small Cap vs. Large Cap (Ibbotson Data).

1979 1999
Risk Return Correlation Risk Return Correlation
Small Cap Stocks 30.8% 17.4% 78.0% 18.1% 16.9% 59.0%
Large Cap Stocks 16.5% 8.1% 13.1% 18.6%

*Reproduced from “Asset Allocation Math, Methods and Mistakes.” Wealthcare Capital Management White Paper, David B. Loeper, CIMA, CIMC (June 2, 2001).

More Problems with MCS

David Nawrocki identified a number of problems with typical MCS as being that most optimizers assume “normal distributions and correlation coefficients of zero, neither of which are typical in the world of financial markets.”

Dr. Nawrocki subsequently describes a number of other issues with MCS including nonstationary distributions and nonlinear correlations.

Finally, Dr. Nawrocki quotes Harold Evensky who eloquently notes that “[t]he problem is the confusion of risk with uncertainty.

Risk assumes knowledge of the distribution of future outcomes (i.e., the input to the Monte Carlo simulation).

Uncertainty or ambiguity describes a world (our world) in which the shape and location of the distribution is open to question.

Contrary to academic orthodoxy, the distribution of U.S. stock market returns is far from “normal”. Other critics have noted that many MCS simulators do not run enough iterations to provide a meaningful probability analysis.

Assessment 

Some of these criticisms have been addressed by using MCS simulators with more robust correlation assumptions and with a greater number of iterative trials. In addition, some simulators now combine MVO and MCS to determine probabilities along the efficient frontier.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors

References:

1. Clark, S.E. and Yates, T.T., Jr. “How Efficient is your Frontier?” Commonfund Institute White Paper (November 2003).

2. Loeper, D.B., CIMA, CIMC. “Asset Allocation Math, Methods, and Mistakes.” Wealthcare Capital Management White Paper (June 2001).

3. Nawrocki, D., Ph.D. “The Problems with Monte Carlo Simulation.” FPA Journal (November 2001).

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Liberation Day Comeback

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The S&P 500 closed within a hair of a new record yesterday marking an enormous comeback that followed the April announcement of “Liberation Day” tariffs.

Despite a persistent vibe of uncertainty related to US economic policy and geopolitics:

  • The S&P 500 closed less than 0.1% away from a record high which it notched in February before cratering nearly 20% in April. The index has regained ground in fits and starts since then and briefly surpassed its record in intra-day trading yesterday.
  • On Monday, the tech-heavy NASDAQ 100 one-upped the broader market and logged its highest-ever close. It came after President Trump said Israel and Iran agreed to a ceasefire, which eased investors’ concerns about a potential oil crisis.

According to Morning Brew, between unresolved geopolitical conflicts and President Trump’s still-unfolding tariff policies, a portfolio manager with Capital Wealth Planning, Kevin Simpson, told CNBC that he was “surprised by the magnitude of the rebound.”

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Deals, Stocks and the FOMC

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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ASSETS UNDER ADVISEMENT: Doctors Only

By Dr. David Edward Marcinko; MBA MEd CMP

A.U.A IS ALL WE DO!

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SPONSOR: http://www.MarcinkoAssociates.com

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

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

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

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D. E. Marcinko & Associates Core Operating Values

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

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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com 

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HEALTHCARE INSURANCE: Marketplace Consumer Fraud

By AI

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Consumer Fraud in the Health Insurance Marketplace

Don’t be a Victim of Consumer Fraud in the Health Care Marketplace 

Beware of…

People asking for money to enroll you in Marketplace or “Obamacare” insurance. Legitimate enrollment agents will NOT ask for money.

High-pressure visits, mail solicitations, e-mails, and phone calls from people pretending to work for the government. No one should threaten you with legal action if you do not sign up for a plan. Always ask for identification if someone comes to your door.

People you did not contact who request personal information. They may be trying to steal your identity. No one from the government will call or email you to sell you an insurance plan or ask for personal identifying information. Be careful when giving out personal information, such as credit card, banking, or Social Security numbers.

Sham websites. Always look for official government seals, logos or website addresses.

Note: If you are a Medicare beneficiary, you do NOT need to buy insurance in the new Health Insurance Marketplace.

Report Marketplace Consumer Fraud: 1-800-318-2596

For more information about using the Marketplace, visit HealthCare.gov . This is the official Marketplace website.

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CRISIS MANAGEMENT: Definition with Big Pharma Example

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By Dr. David Edward Marcinko MBA MED CMP

SPONSOR: wwwCertifiedMedicalPlanner.org

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Crisis Management is the precautions and identification of threats to an organization and its stakeholders, and the methods used by the organization to deal with these threats.

For example, recall in 1982, that Tylenol™ commanded 35 percent of the over-the-counter analgesic market in America and it represented nearly 17 percent of Johnson & Johnson’s profits. But, when seven people died from consuming the tainted drug, a national panic ensued. Moreover, Americans started to question the safety of all over-the-counter medications.

Fortunately, J&J commenced the proto-typical good crisis response in the following way:

  • J&J acted quickly, with complete candidness about what happened and within hours of learning of the deaths, J&J installed toll-free numbers for consumers, sent alerts to healthcare providers nationwide, and stopped advertising the product. J&J recalled 31 million bottles of Tylenol™ capsules and offered replacement products free of charge. J&J did not wait for evidence to see whether the contamination might be more widespread.
  • J&J’s leadership was in the lead and seemed in full control throughout the crisis. The chairman was admired for his leadership to pull Tylenol™ capsules off the market and his forthrightness in dealing with the media. The Tylenol™ crisis led the news every night on every station for six weeks.
  • J&J placed consumers first. J&J spent more than $100 million for the recall and re-launch of Tylenol™. The stock had been trading near a 52-week high just before the tragedy, dropped for a time, but recovered to its highs only two months later.
  • J&J accepted responsibility. The disaster could have been described in many different ways: as an assault on the company, as a problem somewhere in the process of getting Tylenol™ from J&J factories to retail stores, or as the acts of a crazed criminal.
  • J&J sought to ensure that measures were taken to prevent a recurrence of the problem. J&J introduced tamper-proof packaging that would make it much more difficult for a similar incident to occur in the future.
  • J&J presented itself prepared to handle the short-term damage in the name of consumer safety. Within a year of the disaster, J&J’s share of the analgesic market, which had fallen to 7 percent from 37 percent following the poisoning, had climbed back to 30 percent.

This wildly successful response in now the stuff of graduate and business school case models for excellence in teaching!

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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Doctor V. Forensic Pathologist V. Coroner V. Morgue

By Staff Reporters and CoPilot AI

SPONSOR: http://www.CertifiedMedicalPlanner.org

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A morgue is a place where the bodies of dead persons are kept temporarily pending identification or release for burial or autopsy.

TOD: https://medicalexecutivepost.com/2024/02/18/transfer-on-death-account-tax-implications/

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A forensic pathologist is a medical doctor who studies diseases and performs autopsies, while a coroner investigates and determines the cause of sudden or unexplained deaths, often without a medical degree.

An autopsy (also referred to as post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or the exam may be performed to evaluate any disease or injury that may be present for research or educational purposes. The term necropsy is generally used for non-human animals.

DEATH Eco-Friendly: https://medicalexecutivepost.com/2023/05/29/death-eco-friendly-transitions-and-interment/

Autopsies are usually performed by a specialized medical doctor called a pathologist. Only a small portion of deaths require an autopsy to be performed, under certain circumstances. In most cases, a medical examiner or coroner can determine the cause of death.

  • A coroner is elected or appointed to a local government office, while a forensic pathologist is a medical doctor trained to perform autopsies and other procedures to determine the cause of death.
  • A forensic pathologist is able to perform medical operations while coroners may specialize in the legal paperwork and law enforcement side of a death.
  • The title of “medical examiner” is usually the job title of a forensic pathologist who works for a government.
  • In many jurisdictions, a coroner does not need to possess a medical degree.

DEATH CROSS: https://medicalexecutivepost.com/2024/08/23/what-is-the-stock-market-death-cross-2/

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EDUCATION: Books

The Medical Executive-Post is a  news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.

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MUTUAL FUNDS, SECTOR FUNDS, ETFs & INDEX FUNDS

By Dr. David Edward Marcinko MBA MEd CMP

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MUTUAL FUNDS, SECTOR FUNDS, ETFs AND INDEX FUNDS

SPONSOR: http://www.MarcinkoAssociates.com

here are many ways for a doctor, osteopath, podiatrist or dentist to financially invest. Traditionally, this meant picking individual stocks and bonds. Today, there are many other ways to purchase securities en mass. For example:

MUTUAL FUND: A regulated investment company that manages a portfolio of securities for its shareholders.

Open End Mutual Funds: An investment company that invests money in accordance with specific objectives on behalf of investors. Fund assets expand or contract based on investment performance, new investments and redemptions. Trade at Net Asset Value or the price the fund shares scheduled with the US Securities and Exchange Commission (SEC) trade. NAV can change on a daily basis. Therefore, per-share NAV can, as well.

Closed End Mutual Funds: Older than open end mutual funds and more complex. A CEMF is an investment company that registers shares SEC regulations and is traded in securities markets at prices determined by investments. Shares of closed-end funds can be purchased and sold anytime during stock market hours. CEMF managers don’t need to maintain a cash reserve to redeem or / repurchase shares from investors. This can reduce performance drag that may otherwise be attributable to holding cash. CEMFs may be able to offer higher returns due to the heavier use of leverage [debt]. They are subject to volatility, less liquid than open-end funds, available only through brokers and may sells at a heavily discount or premium to [NAV] determined by subtracting its liabilities from its assets. The fund’s per-share NAV is then obtained by dividing NAV by the number of shares outstanding.  .

Sector Mutual Funds: Sector funds are a type of mutual fund or Exchange-Traded Fund (ETF) that invests in a specific sector or industry such as technology, healthcare, energy, finance, consumer goods, or real estate. Sector funds focus on a particular industry, allowing investors to gain targeted exposure to specific market areas. The goal is to outperform the overall market by investing in companies within a specific sector that is expected to perform well. However, they are also more susceptible to market fluctuations and specific sector risks, making them a more specialized and potentially higher-risk investment option.

STOCKS, BONDS AND MUTUAL FUNDS: https://medicalexecutivepost.com/2025/06/11/stocks-bonds-and-commodities/

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EXCHANGE TRADED FUNDS:  ETFs are a type of fund that owns various kinds of securities, often of one type. For example, a stock ETF holds stocks, while a bond ETF holds bonds. One share of the ETF gives buyers ownership of all the stocks or bonds in the fund. If an ETF held 100 stocks, then those who owned the fund would own a stake – albeit a very tiny one – in each of those 100 stocks.

ETFs are typically passively managed, meaning that the fund usually holds a fixed number of securities based on a specific preset index of investments. These are tax efficient. In contrast, many mutual funds are actively managed, with professional investors trying to select the investments that will rise and fall.

The Standard & Poor’s 500 Index is perhaps the world’s best-known index, and it forms the basis of many ETFs. Other popular indexes include the Dow Jones Industrial Average and the National Association of Securities Dealers Automated Quotations [NASDAQ] Composite Index.

ETFs based on these funds are called Index Funds and just buy and hold whatever is in the index and make no active trading decisions. ETFs trade on a stock exchange during the day, unlike mutual funds that trade only after the market closes. With an ETF you can place a trade whenever the market is open and know exactly the price you’re paying for the fund.

ETFs: https://medicalexecutivepost.com/2025/01/06/etfs-alternatively-weighted-investments/

INDEX FUNDS: Index funds mirror the performance of benchmarks like the DJIA. These passive investments are an unimaginative way to invest. Passive index funds tracking market benchmarks accounted for just 21% of the U.S. equity fund market in 2012. By 2024, passive index funds had grown to about half of all U.S. fund assets. This rise of passive funds has come as they often outperform their actively managed peers. According to the widely followed S&P Indices Versus Active (SPIVA) scorecards, about 9 out of 10 actively managed funds didn’t match the returns of the S&P 500 benchmark in the past 15 years.

ASSESSMENT

Investing in individual stocks is psychologically and academically different than investing in the above funds, according to psychiatrist and colleague Ken Shubin-Stein MD, MPH, MS, CFA who is a professor of finance at the Columbia University Graduate School of Business  When you buy shares of a company, you are putting all your eggs in one basket. If the company does well, your investment will go up in value. If the company does poorly, your investment will go down. Fund diversification helps reduce this risk.

CONCLUSION

Investing in the above fund types will help mitigate single company security risk.

References: 

1. Fenton, Charles, F: Non-Disclosure Agreements and Physician Restrictive Covenants. In, Marcinko, DE and Hetico, HR: Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]. Productivity Press, New York, 2015.

Readings:

1. Marcinko, DE and Hetico, HR; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017 

2. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006

3.  https://www.ft.com

4. Shubin-Stein, Kenneth: Unifying the Psychological and Financial Planning Divide [Holistic Life Planning, Behavioral Economics, Trading Addiction and the Art of Money]. Marcinko, DE and Hetico, HR; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017

COMMENTS APPRECIATED

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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DOCTOR INVESTING MISTAKES: Top Five PLUS 1 Vital Tip

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By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.MarcinkoAssociates.com

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FIVE INVESTING MISTAKES OF DOCTORS; PLUS 1 VITAL TIP

As a former US Securities and Exchange Commission [SEC] Registered Investment Advisor [RIA] and business school professor of economics and finance, I’ve seen many mistakes that doctors must be aware of, and most importantly, avoid. So, here are the top 5 investing mistakes along with suggested guideline solutions.

Mistake 1: Failing to Diversify Investment but Beware Di-Worsification

A single investment may become a large portion of your portfolio as a result of solid returns lulling you into a false sense of security. The Magnificent Seven stocks are a current example:

  • Apple, up +5,064%% since 1/18/2008 
  • Amazon, up +30,328% since 9/6/2002 
  • Alphabet, up +1,200% since 7/20/2012 
  • Tesla, up +21,713% since 11/16/2012 
  • Meta, up +684% since 2/20/2015 
  • Microsoft, up +22% since 12/21/2023 
  • Nvidia, up +80,797% since 4/15/2005 

Guideline: The Magnificent Seven [7] has grown from 9% of the S&P 500 at the end of 2013 to 31% at the end of 2024! That means even if you don’t own them, you’re still very exposed if you have an Index Fund [IF] or Exchange Traded Fund [ETF] that tracks the market. Accordingly, diversification is the only free lunch in investing which can reduce portfolio risk. But, remember the Wall Street insider aphorism that states: “Di-Versification Means Always Having to Say Your Sorry.” 

The term “Di-Worsification” was coined by legendary investor Peter Lynch in his book, One Up On Wall Street to refer to over-diversifying an investment portfolio in such a way that it reduces your overall risk-return characteristics. In other words, the potential return rises with an increase in risk and invested money can render higher profits only if willing to accept a higher possibility of losses [1].

IPO: https://medicalexecutivepost.com/2025/03/02/ipo-road-show-with-pros-and-cons/

Mistake 2: Chasing Stock Market Performance

A podiatrist can easily fall into the trap of chasing securities or mutual funds showing the highest return. It is almost an article of faith that they should only purchase mutual funds sporting the best recent performance. But in fact, it may actually pay to shun mutual funds with strong recent performance. Unfortunately, many struggle to appreciate the benefits of their investment strategy because in jaunty markets, people tend to run after strong performance and purchase last year’s winners. 

Similarly, in a market downturn, investors tend to move to lower-risk investment options, which can lead to missed opportunities during subsequent market recoveries. The extent of underperformance by individual investors has often been the most awful during bear markets. Academic studies have consistently shown that the returns achieved by the typical stock or bond fund investors have lagged substantially.

Guideline: Understand chasing performance does not work.Continually monitor your investments and don’t feel the need to invest in the hottest fund or asset category.  In fact, it is much better to increase investments in poor performing categories (i.e. buy low). Also keep in remind rebalancing of assets each year is key. If stocks perform poorly and bonds do exceptionally well, then rebalance at the end of the year. In following this strategy, this will force a doctor into buying low and selling high each year. 

STOCKS: https://medicalexecutivepost.com/2025/04/18/stocks-basic-definitions/

Mistake 3: Assuming Annual Returns Follow Historical Averages

Often doctors make their investment decisions under the belief that stocks will consistently give them solid double-digit returns. But the stock markets go through extended long-term cycles.

In examining stock market history, there have been 6 secular bull markets (market goes up for an extended period) and 5 secular bear markets (market goes down) since 1900. There have been five distinct secular bull markets in the past 100+ years. Each bull market lasted for an extended period and rewarded investors.   

For example, if an investor had started investing in stocks either at the top of the markets in 1966 or 2000, future stock market returns would have been exceptionally below average for the proceeding decade. On the other hand, those investors fortunate enough to start building wealth in 1982 would have enjoyed a near two-decade period of well above average stock market returns.  They key element to remember is that future historical returns in stocks are not guaranteed. If stock market returns are poor, one must consider that he or she will have to accept lower projected returns and ultimately save more money to make up for the shortfall. For example,

The May 6th, 2010, flash crash, also known as the crash of 2:45, was a United States trillion-dollar stock market plunge which started at 2:32 pm EST and lasted for approximately 36 minutes.

And, investors who have embraced the “buy the dip” strategy in 2025 have been handsomely rewarded, with the S&P 500 delivering its strongest post-pull back returns in over three decades.

According to research from Bespoke Investment Group, the S&P 500 has gained an average of 0.36% in the trading session following a down day so far in 2025. The only year with a comparable performance was 2020, which saw a 0.32% average post-dip gain [2]. 

The most recent example came on May 27, 2025 when the S&P 500 surged more than 2% after falling 0.7% in the final session before the holiday weekend. The rally was sparked by President Trump’s decision to scale back huge previously threatened tariffs on EU —a recurring catalyst behind many of 2025’s rebound. 

Guideline: Beware of projecting forward historical returns. Doctors should realize that the stock markets are inherently volatile and that, while it is easy to rely on past historical averages, there are long periods of time where returns and risk deviate meaningfully from historical averages.

REVENUE BONDS: https://medicalexecutivepost.com/2024/12/20/bonds-revenue/

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Mistake 4: Attempting to Time the Stock Market

Some doctors believe they are “smarter than the market” and can time when to jump in and buy stocks or sell everything and go to cash. Wouldn’t it be nice to have the clairvoyance to be out of stocks on the market’s worst days and in on the best days?  

Using the S&P 500 Index, our agile imaginary doctor-investor managed to steer clear of the worst market day each year from January 1st, 1992 to March 31st, 2012. The outcome: s/he compiled a 12.42% annualized return (including reinvestment of dividends and capital gains) during the 20+ years, sufficient to compound a $10,000 investment into $107,100.

But what about another unfortunate doctor-investor that had the mistiming to be out of the market on the best day of each year. This ill-fated investor’s portfolio returned only 4.31% annualized from January 1992 – March 2012, increasing the $10,000 portfolio value to just $23,500 during the 20 years. The design of timing markets may sound easy, but for most all investors it is a losing strategy. 

More contemporaneously on December 18th 2024, the DJIA plummeted 2.5%, while the S&P 500 declined 3% and the NASDAQ tumbled 3.5% 

Guideline: If it looks too good to be true, it probably is. While jumping into the market at its low and selling right at the high is appealing in theory, we should recognize the difficulties and potential opportunity and trading costs associated with trying to time the stock market in practice. In general, colleagues are be best served by matching their investment with their time horizon and looking past the peaks / valleys along the way.

ALTERNATIVE INVESTMENTS: https://medicalexecutivepost.com/2025/05/12/stocks-and-alternative-investments/

Mistake 5: Failing to Recognize the Impact of Fees and Expenses

A free dinner seminar or a polished stock-broker sales pitch may hide the total underlying costs of an investment.  So, fees absolutely matter.

The first costing step is determining what the fees actually are. In a mutual fund, these costs are found in the company’s obligatory “Fund Facts”. This manuscript clearly outlines all the fees paid–including up front fees (commissions and loads), deferred sales charges and any switching fees. Fund management expense ratios are also part of the overall cost. Trading costs within the fund can also impact performance. 

Here is a list of the traditional mutual fund fees:

  • Front End Load: The commission charged to purchase a fund through a stock broker or financial advisor. The commission reduces the amount you have available to invest.  Thus, if you start with $100,000 to invest, and the advisor charges up to an 8 percent front end load, you end up actually investing $92,000.
  • Deferred Sales Charge (DSC) or Back End Load: Imposed if you sell your position in the mutual fund within a pre-specified period of time (normally one – five years).  It is initiated at a higher start percentage (i.e. as high as 10 percent) and declines over a specific period of time.
  • Operating Fees: Costs of the mutual fund including the management fee rewarded to the manager for investment services. It also includes legal, custodial, auditing and marketing fees.
  • Annual Administration Fee:  Many mutual fund companies also charge a fee just for administering the account – usually under $100-150 per year.

Guideline: Know and understand all fees.

For example: A 1 percent disparity in fees may not seem like much but it makes a considerable impact over a long time period. 

Consider a $100,000 portfolio that earns 8 percent before fees, grows to $320,714 after 20 years if the investor pays a 2 percent operating fee. In comparison, if s/he opted for a fund that charged a more reasonable 1 percent fee, after 20 years, the portfolio grows to be $386,968 – a divergence of over $66,000! 

This is the value of passive or index investing. In the case of an index fund, fees are generally under 0.5 percent, thus offering even more savings over a long period of time. 

One Vital Tip: Investing Time is on Your Side

Despite thousands of TV shows, podcasts, textbooks, opinions and university studies on investing, it really only has three simple components. Amount invested, rate of return and time. By far, the most important item is time! For example:

  • Nvidia: if you invested $1,000 in 2009, you’d have $338,103 today.
  • Apple: if you invested $1,000 in 2008, you’d have $48,005 today.
  • Netflix: if you invested $1,000 in 2004, you’d have $495,679 today.

Start prudently investing now and do not wait!

ETFs: https://medicalexecutivepost.com/2025/01/06/etfs-alternatively-weighted-investments/

CONCLUSION

Unfortunately, this list of investing mistakes is still being made by many doctors. Fortunately, by recognizing and acting to mitigate them, your results may be more financially fruitful and mentally quieting.

REFERENCES:

1. Lynch, Peter: One Up on Wall Street [How to Use What You Already Know to Make Money in the Market]: Simon and Shuster (2nd edition) New York, 2000.

2. https://www.bespokepremium.com

Readings:

1. Marcinko, DE; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017. 

2. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, New York, 2006.

3. Marcinko, DE; Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] CRC Press, New York, 2015.

BIO: As a former university Professor and Endowed Department Chair in Austrian Economics, Finance and Entrepreneurship, the author was a NYSE Registered Investment Advisor and Certified Financial Planner for a decade. Later, he was a private equity and wealth manager

COMMENTS APPRECIATED

SPONSOR: http://www.CertifiedMedicalPlanner.org

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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HEDGE FUNDS: Defined for Doctors

By Dr. David Edward Marcinko MBA MEd CMP

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WHAT IS A HEDGE FUND?

SPONSOR: http://www.MarcinkoAssociates.com

Many doctors are surprised to learn of an alternative investment known as a hedge fund, pooled investment vehicle or private investment fund. Unlike mutual funds, they can be structured in many ways. However, these funds cannot be marketed or advertised, but they are far from illegal or illicit.

In fact, physicians were among the early investors in one the most successful hedge funds. Warren Buffett got his start in 1957 running the Buffett Partnership, a hedge fund not open to the public. His first appearance as a money manager was before a group of physicians in Omaha, Nebraska. Eleven decided to invest some money with him. A few then followed into Berkshire Hathaway Inc, now among the most highly valued companies in the world.

And, more recently, Scion Asset Management® LLC, is a private investment firm founded and led by my eloquent colleague Michael J. Burry, MD and featured in the movie, The Big Short. Other hedge fund mangers of note include: George Soros, Carl Icahn, Ken Griffin, David Tepper, John Paulson and Bill Ackman.

MASTER FEEDER FUND: https://medicalexecutivepost.com/2025/05/27/master-feeder-structure-hedge-funds/

Definition

A hedge fund is a limited partnership of private investors whose money is managed by professional fund managers who use a wide range of strategies; including leveraging [debt] or trading of non-traditional assets [real-estate, collectible, commodities, cyrpto-currency, etc] to earn above-average returns. Hedge funds are considered a risky alternative investment and usually require a high minimum investment or net worth. This person is known as an “accredited investor” or “Regulation D” investor by the US Securities Exchange Commission and must have the following attributes:

  • A net worth, combined with spouse, of over $1 million, not including primary residence
  • An income of over $200,000 individually, or $300,000 with a spouse, in each of the past two years

MANAGERS: https://medicalexecutivepost.com/2025/05/23/hedge-fund-hiring-separate-managers/

TERMS AND FEES

Hurdle Rate

The hurdle rate is part of the fund manager’s performance incentive compensation. Also known as a “benchmark,” it is the amount, expressed in percentage points an investor’s capital must appreciate before it becomes subject to a performance incentive fee. Podiatrists should view the hurdle rate as a form of protection or the fee arrangement.

The hurdle rate benchmarks a single year’s performance and may be considered mutually exclusive of any other year, or the hurdle rate may compound each year. The former case is more common. In the latter case, a portfolio manager failing to attain a hurdle rate in the first year will find the effective hurdle rate considerably higher during the second year.

Once a fund manager attains the hurdle rate, the investor’s capital account may be charged a performance incentive fee only on the performance above and beyond the hurdle rate. Alternatively, the account may be charged a performance fee for the entire level of performance, including the performance required to attain the hurdle rate. Other variations on the use of the hurdle rate exist, and are limited only by the contract signed between the fund manager and the investor. The hurdle rate is not generally a negotiating point, however.

Example: A fund charges a performance fee with a 6 percent hurdle rate, calculated in mutually exclusive manner. A podiatrist places $100,000 with the fund. The first year’s performance is 5 percent. The doctor therefore owes no performance fee during the first year because the portfolio manager did not attain the hurdle rate. During year two, the portfolio manager guides the fund to a 7 percent return. Because the hurdle rate is mutually exclusive of any other year, the portfolio manager has attained the 6 percent hurdle rate and is entitled to a performance fee.

High Water Mark

Some hedge funds feature a “high water mark” provision known as a ”loss-carry forward.” As with the hurdle rate, the high water mark is a form of protection. It is an amount equal to the greatest value of an investor’s capital account, adjusted for contributions and withdrawals. The high water mark ensures that the manager charges a performance incentive fee only on the amount of appreciation over and above the high water mark set at the time the performance fee was last charged. The current trend is for newer funds to feature this high water mark, while older, larger funds may not feature it.

Example: A fund charges a 20 percent performance fee with a high water mark but no hurdle rate. A podiatrist contributes $100,000 to the fund. During the first year, the hedge fund manager grows that capital account to $110,000 and charges a 20 percent performance fee, or $2,000. The ending capital account balance and high water mark is therefore $108,000. During year two, the account falls back to $100,000, but the high water mark remains $108,000. During year three, in order for the manager to charge a performance fee, the manager must grow the capital account to a level above $108,000.

Claw Back Provision

Rarely, a hedge fund may provide investors with a “claw back” provision. This term results in a refund to the investor of all or part of a previously charged performance fee if a certain level of performance is not attained in subsequent years. Such refunds in the face of poor or inadequate performance may not be legal in some states or under certain authorities.

ASSESSMENT

Managers of hedge funds, like colleague Dimitri Sogoloff MBA who is the CEO of Horton Point investment-technology firm, often aim to produce returns that are relatively uncorrelated with market indices and are consistent with investors’ desired level of risk.

While hedging may reduce some risks overall, they cannot all be eliminated. According to a report by the Hennessee Group, hedge funds were approximately one-third less volatile between 1993 and 2010.

HEDGE FUND PENSION PLANS: https://medicalexecutivepost.com/2025/05/18/medical-practice-pension-plan-hedge-fund-difficulties/

CONCLUSION

For a podiatrist who already holds mutual funds and/or individual stocks and bonds, a hedge fund may provide diversification and reduce overall portfolio risk. Consider investing in them with care.

References and Readings:

1. https://www.scionasset.com 

2. Burry, Michael, J: Hedge Funds [Wall Street Personified]. In, Marcinko, DE and Hetico, HR: Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017.

3. Marcinko, DE and Hetico, HR: Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]. Productivity Press, New York, 2015.

4. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006

5. https://www.hortonpoint.com/

6. http://hennesseegroup.com

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

COMMENTS APPRECIATED

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FINANCIAL ADVISORY FEES: What All Doctors Must Know

SPONSOR: http://www.MarcinkoAssociates.com

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By Dr. David Edward Marcinko MBA MEd CMP

WHAT YOU “MUST KNOW“ ABOUT FINANCIAL ADVISORY FEES

Investment fees still matter despite dropping dramatically over the past several decades due to computer automation, algorithms and artificial intelligence, etc. And, they can make a big difference to your financial health. So, before buying any investment, it’s vital to uncover all real financial advisor and stock broker costs.

HEDGE FUND FEES: https://medicalexecutivepost.com/2025/04/18/stocks-basic-definitions/

SIX TYPES OF FEES AND EXPENSES

1. Up-front salesperson commissions. It is easy to ask; “If I buy this investment today and want to get out tomorrow, how much money do I get back?” If the answer is not “all your money,” the difference is probably upfront fees and commissions. These fees may run as high as 30% of the money invested. If you were to earn 5% a year on the investment, it would take 8 years just to break even.

2. Ongoing advisory fees. These are monthly, quarterly, or annual fees paid to advisors for their investment advice and oversight. This includes working with you to pick the asset classes, set diversification, select a portfolio manager, optimize taxes, re-balance holdings and other periodic tasks.

These fees have many names including wrap fee or investment advisory fees. The normal “rule of thumb” is 1% of assets managed, although fees can range from 0 to 7%. Today, it can even be as low as .5%. It can be charged even if the advisor receives an upfront commission. It can be easy to see, or hidden in the fine print.

3. Additional service fees. Find out specifically what services are included financial advisory fees. Additional fees for financial planning or other services are rarely disclosed. They can range from minimal hand-holding focused on your investments to comprehensive financial planning.

4. Ongoing managerial expense ratio fees. These are incredibly well hidden that you may not see them in your statements or invoices. The only way to know is to read the prospectus or other third party analysis, like Morningstar.com. And, they can vary greatly for the same investment, depending on the class of share you buy.

For example, American Fund’s New Perspective Fund’s expense ratio ranges from 0.45% to 1.54%.  The average expense ratio of a mutual fund that invests in stocks is 1.35%. Conversely, the average expense ratio of a Vanguard S&P 500 Fund is 0.10%. The difference of 1.25% is staggering over time.

5. Miscellaneous fees. Some advisors charge $50 – $100 a year per account to open or close an account, and even fees to dollar cost average your funds into the market.

6. Transaction fees. Every time you buy or sell a fund, a fee is typically paid to a custodian. These can range from $5 to hundreds of dollars per transaction.

7. Fee Only: Paid directly by clients for their services and can’t receive other sources of compensation, such as payments from fund providers. Act as a fiduciary, meaning they are obligated to put their clients’ interests first

8. Fee Based: Paid by clients but also via other sources, such as commissions from financial products that clients purchase. Brokers and dealers (or registered representatives) are simply required to sell products that are “suitable” for their clients.

A “suitable” investment is defined by FINRA as one that fits the level of risk that an investor is willing and able, as measured by personal financial circumstances, to take on. The Financial Industry Regulatory Authority is a private American corporation that acts as a Self Regulatory Organization (SRO) that regulates member stock brokerage firms and exchange markets. These criteria must be met. It is not enough to state that an investor has a risk-friendly investment profile. In addition, they must be in a financial position to take certain chances with their money. It is also necessary for them to

A hedge fund is a limited partnership of private investors whose money is managed by professional fund managers who use a wide range of strategies; including leveraging [debt] or trading of non-traditional assets [real-estate, collectible, commodities, cyrpto-currency, etc] to earn above-average returns. Hedge funds are considered a risky alternative investment and usually require a high minimum investment or net worth. This person is known as an “accredited investor” or “Regulation D” investor by the US Securities Exchange Commission and must have the following attributes:

  • A net worth, combined with spouse, of over $1 million, not including primary residence
  • An income of over $200,000 individually, or $300,000 with a spouse, in each of the past two years

Not a fiduciary.

Ways to minimize fees

Choose the fee structure. The fee structure should align with your needs. Consider the type of advice you seek, the number of times needed and the complexity of your financial situation. You can always negotiating tactics are free to ask for a better deal.

Compare fees. It is essential to research and compare different fees. Be sure to read the fine print for details or costs that are not a base fee.

Robo-advisors: For simple investment goals, with little specificity, robo-advisors may be a cost-effective option. They charge lower fees than conventional financial advisors and provide an automated, algorithmic approach to managing your investments. 

Assessment

The average cost of working with a human financial advisor in 2024 was 0.5% to 2.0% of assets managed, $200 to $400 per hourly consultation, a flat fee of $1,000 to $3,000 for a one-time service, and/or a 3% to 6% commission fee on the product types sold.

ADVISORY FEES: https://medicalexecutivepost.com/2025/02/26/be-aware-financial-advisory-fees-fee-based-versus-fee-only/

Conclusion

When ruminating over financial advisory fees; read and understand the contract with disclosures, do not sign a confidentiality or non-disclosure agreement, and do not waive your right to a lawsuit. According to colleague Dr. Charles F. Fenton IIII JD, forced legal settlements almost always favor the advisor over the client.

References and Readings:

1. https://www.capitalgroup.com [American Funds]

2. Marcinko, DE and Hetico, HR; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017. 

3. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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INVESTING: Stocks, Bonds & Oil Updates

Generated by AI

SPONSOR: http://www.CertifiedMedicalPlanner.org

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  • Stocks: The S&P 500 touched 6,000 points for the first time since February and wrapped up its fifth positive week in the past seven following a better-than-expected jobs report. The vibes got even better in the afternoon following a President Trump announcement that the US and China trade teams will meet in London on Monday. STOCKS: https://medicalexecutivepost.com/2025/04/18/stocks-basic-definitions/
  • Bonds: Treasury yields ticked up in response to the solid May jobs report, a sign that investors were reducing bets on the scale of rate cuts this year. That’s not what Trump wants to hear: He urged Fed Chair Jerome Powell to slash interest rates by a jumbo-sized full point to pour “rocket fuel” on the economy. REVENUE BONDS: https://medicalexecutivepost.com/2024/12/20/bonds-revenue/
  • Oil: Oil prices have gone sideways for three straight weeks now, trading within a $4 range around $65/barrel since the middle of May. We’ll let you know when something interesting happens. CRUDE OIL: https://medicalexecutivepost.com/2024/08/14/wti-crude-oil/

EDUCATION: Books

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EMPLOYMENT: Growing Slowly

By AI

BREAKING NEWS

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Job growth is slowing, but still bigger than expected

US employers added 139,000 jobs last month, government data released yesterday shows—that’s less than the down-wardly revised 147,000 new jobs that were added in April, but more than economists had predicted. Meanwhile, the unemployment rate held steady.

MAY: https://medicalexecutivepost.com/2025/06/06/may-jobs-report/

Overall, the highly anticipated jobs report reflects employers growing more cautious in the face of the economic uncertainty brought on by the trade war, but so far, there doesn’t seem to be a steep drop off in the labor market. That could give the Fed reason to stay in wait-and-see mode on interest rates, though President Trump still used the occasion to urge Jerome Powell to cut rates “a full point” on Truth Social.

PHYSICIAN EMPLOYMENT CONTRACTS: https://medicalexecutivepost.com/2024/01/12/sample-new-physician-letter-of-employment-contract/

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MAY: Jobs Report

BREAKING NEWS!

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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Markets: Stocks fell yesterday as investors readied themselves for today’s jobs report. The May jobs report is expected to show hiring slowed while the unemployment rate held flat. The data release will come as investors closely watch for any further signs of slowing in the US labor market.

CPI: https://medicalexecutivepost.com/2024/07/13/what-is-the-elderly-cpi/

The Bureau of Labor Statistics data is slated for release at 8:30 a.m. ET, today. Economists expect non-farm payroll to have risen by 125,000 in May and the unemployment rate to have held steady at 4.2%, according to consensus estimates compiled by Bloomberg.

PPI: https://medicalexecutivepost.com/2024/07/13/what-is-the-producer-price-index/

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INVESTING: Wrap-Up

By Staff Reporters and Brew Markets

SPONSOR: http://www.CertifiedMedicalPlanner.org

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RISK MANAGEMENT FOR PHYSICIANS

https://www.amazon.sa/-/en/Risk-Management-Liability-Insurance-Asset/dp/1032917636

Tariffs, Private Sector Jobs, Interest Rates, Gold and the US Dollar

BREAKING NEWS!

By Staff Reporters with AI Generation

SPONSOR: http://www.CertifiedMedicalPlanner.org

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  • 50% tariffs on steel and aluminum went into effect today. To celebrate, President Trump hopped on Truth Social to put China’s President Xi on blast ahead of an expected call between the two heads of state. And, Temu lost 58% of its daily users thanks to tariffs.
  • The president also pushed Jerome Powell to “LOWER THE RATE” following terrible private sector job numbers. Stocks are seemingly immune to tough trade talk and interest rate rants at this point, but bond yields sank on fears of slower economic growth.
  • The US dollar slipped, propelling gold higher as investors sought safety.

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PROXY VOTE: Defined


This ME-P was developed with AI-powered tools and reviewed by Editors

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is in a proxy statement? 

A proxy statement tells you a lot about a company’s management and board of directors, providing details about compensation, large shareholders, and the accounting firm that audits the company books. It also includes information about shareholder resolutions and the board’s responses to those proposals.

Each publicly traded company files a proxy statement with the Securities and Exchange Commission (SEC) every year, and it’s used by shareholders to help cast votes on their proxy ballots. The board may provide recommendations to vote for or against a proposal, but investors should do their best to collect the facts and make a decision on their own.

HOSTILE TAKEOVER: https://medicalexecutivepost.com/2025/03/24/hostile-company-takeover-definition-defense-pharmaceutical-company-example/

What is in a proxy Vote? 

According to Motley Fool, about once every year, for most companies, you will have the right to vote your shares on a variety of topics related to the companies you own in your portfolio. These are called proxy votes. Regular individual shareholders generally receive one vote per share owned. Some companies have multiple classes of shares, and management and other insiders will have a higher level of voting power (for example, 10 votes per share).

COMMON STOCK: https://medicalexecutivepost.com/2008/02/12/what-is-common-stock/

Every year, you will receive a proxy statement in the mail or electronically. This document gives you insight into a variety of important issues to consider and vote on using your proxy ballot.

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EDUCATION: Books

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QUISHING: Scams Defined

QR Code Cyber Security Scams

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Cloudflare and AI

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What is quishing?

Quishing, or QR phishing, is a cybersecurity threat in which attackers use QR codes to redirect victims to malicious websites or prompt them to download harmful content. The goal of this attack is to steal sensitive information, such as passwords, financial data, or personally identifiable information (PII), and use that information for other purposes, such as identity theft, financial fraud, or ransomware.

This type of phishing often bypasses conventional defenses like secure email gateways. Notably, QR codes in emails are perceived by many secure email gateways as meaningless images, making the users vulnerable to specific forms of phishing attacks. QR codes can also be presented to intended victims in a number of other ways.

MISHING: https://medicalexecutivepost.com/2025/02/28/mishing-a-mobile-first-phishing-technique/

What are QR codes?

QR codes, or Quick Response codes, are two-dimensional barcodes that can be scanned easily with a camera or a code reader application. The main component of a QR code is data storage. QR codes have the capability to store significant amounts of information including URLs, product details, or contact information. Scanning technology allows smartphone cameras or code readers to easily and quickly access the website to which the URL points.

SMISHING: https://medicalexecutivepost.com/2025/01/08/smishing-beware-scams/

How does quishing work?

In a quishing attack, the attackers create a QR code and link it to a malicious website. Typically, the attacker will embed the QR code in phishing emails, social media, printed flyers, or physical objects, and use social engineering techniques to entice the victims. For example, victims might receive an email urging them to access an encrypted voice message via a QR code for a chance to win a cash prize.

Upon using their phones to scan the QR code, victims are directed to the malicious site. The site may prompt victims to enter private information, such as login information, financial details, or personal information. In the example above, the site may request the user’s name, email, address, date of birth, or account login information.

Once this sensitive information is captured, attackers can exploit it for various malicious purposes, including identity theft, financial fraud, or ransomware.

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THOUGHT EXPERIMENT: The Colorblind Neuroscientist

By Staff Reporters and AI

SPONSOR: http://www.CertifiedMedicalPlanner.org

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THOUGHT EXPERIMENT DEFINED

A thought experiment is a mental exercise where you imagine a situation or scenario to explore an idea, test a theory, or examine a problem. It does not involve physical experiments or data. Instead, it uses reasoning, imagination, and logic to draw conclusions or raise important questions.

INATTENTIONAL BLINDNESS: https://medicalexecutivepost.com/2025/03/11/inattentional-blindness/

Colorblind Neuroscientist [Inverted Spectrum Problem]

Sometimes referred to as the Inverted Spectrum Problem or the Knowledge Argument, this thought experiment is meant to stimulate discussions against a purely physical view of the universe, namely the suggestion that the universe, including mental processes, is entirely physical. This thought experiment tries to show that there are indeed non-physical properties — and attainable knowledge — that can only be learned through conscious experience.

The originator of the concept, Frank Jackson, explains it this way:

Mary is a brilliant scientist who is, for whatever reason, forced to investigate the world from a black and white room via a black and white television monitor. She specializes in the neuro-physiology of vision and acquires, let us suppose, all the physical information there is to obtain about what goes on when we see ripe tomatoes, or the sky, and use terms like ‘red’, ‘blue’, and so on. She discovers, for example, just which wavelength combinations from the sky stimulate the retina, and exactly how this produces via the central nervous system the contraction of the vocal cords and expulsion of air from the lungs that results in the uttering of the sentence ‘The sky is blue’…What will happen when Mary is released from her black and white room or is given a color television monitor? Will she learn anything or not?

Put another way, Mary knows everything there is to know about color except for one crucial thing: She’s never actually experienced color consciously. Her first experience of color was something that she couldn’t possibly have anticipated; there’s a world of difference between academically knowing something versus having actual experience of that thing.

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DIVIDEND STOCK ARISTOCRATS: Pros and Cons

By AI

SPONSOR: http://www.CertifiedMedicalPlanner.org

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SPONSOR: http://www.MarcinkoAssociates.com

According to wikipedia, the S&P 500 Dividend Aristocrats is a stock market index composed of the companies in the S&P 500 index that have increased their dividends in each of the past 25 consecutive years. It was launched in May 2005.

There are other indexes of dividend aristocrats that vary with respect to market cap and minimum duration of consecutive yearly dividend increases. Components are added when they reach the 25-year threshold and are removed when they fail to increase their dividend during a calendar year or are removed from the S&P 500. However, a study found that the stock performance of companies improves after they are removed from the index The index has been recommended as an alternative to bonds for investors looking to generate income.

To invest in the index, there are several exchange traded funds (ETFs), which seek to replicate the performance of the index.

STOCK DIVIDENDS: https://medicalexecutivepost.com/2025/03/02/stock-dividends-company-earnings-distribution/

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And so, to clarify, the following are the advantages and disadvantages of US dividend aristocrats:

Advantages

  1. They certainly display consistent, blue-chirp corporations with an extended history of vital funds and dividend increments.
  2. Additionally, these stocks offer fixed revenue growth.
  3. In other words, they tend to possess lower price volatility.
  4. Please note that dividend investing supporters prefer a credible income source.
  5. They are sufficiently stable for continuous annual dividend increments across decades, certainly even through recessions.
  6. Above all, it helps quicker portfolio building through reinvestment in these stocks.
  7. They certainly ensure successful long-term investing.
  8. Regarded as among the most famous investment strategies, they relish extensive consumer confidence.

Disadvantages

  1. To clarify, they are considered taxable earnings.
  2. In other words, they offer a lack of control over their distribution timing.
  3. Above all, these shares have under performed S&P 500.
  4. Company development certainly consumes a lot of time.
  5. Additionally, they are subject to market fluctuations.
  6. Moreover, they are considered unimaginative.

STOCK: https://medicalexecutivepost.com/2024/08/20/preferred-versus-common-stock/

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DONOR ADVISED FUND: Defined

WHAT IS A DONOR ADVISED FUND?

Sponsor: http://www.CertifiedMedicalPlanner.org

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A donor-advised fund is a private account created to manage and distribute charitable donations on behalf of an organization, family, or individual. Donor-advised funds can democratize philanthropy by aggregating the contributions of multiple donors, thus multiplying their impact on worthy causes. Donor-advised funds also have abundant tax advantages.

DONOR DEPENDENCY: https://medicalexecutivepost.com/2025/01/02/culture-donation-dependency/

Donor-advised funds have become increasingly popular, as they offer the donor greater ease of administration while still allowing them to maintain significant control over the placement and distribution of charitable gifts. But, unlike private foundations, donor-advised fund holders enjoy a federal income tax deduction of up to 60% of adjusted gross income (AGI) for cash contributions and up to 30% of AGI for the appreciated securities they donate. Donors to these funds can contribute cash, stock shares, and other assets. When they transfer assets such as limited-partnership interests, they can avoid capital gains taxes and receive immediate fair market value tax deductions.

MEDICAL ETHICS: https://medicalexecutivepost.com/2024/06/20/medical-ethics-physician-and-financial-organizations/

According to the National Philanthropic Trust’s 2023 Donor-Advised Fund Report, these funds have continued to grow in recent years, despite some headwinds including the Covid-19 pandemic and occasional stock market setbacks. Total grants awarded by donor-advised funds in 2022 increased by 9% to $52.16 billion, while total contributions rose by 9% to $85.5 billion.

Many donor-advised funds accept non-cash assets—such as checks, wire transfers, and cash positions from a brokerage account—in addition to cash and cash equivalents.

Donating non-cash assets may be more beneficial for individuals and businesses, leading to bigger tax bigger write-offs.

PHILANTHROPY: https://medicalexecutivepost.com/2021/11/15/national-philanthropy-day-2021/

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ABOUT: Marcinko Associates; Inc.

By Dr. David Edward Marcinko; MBA MEd CMP

PRACTICE MANAGEMENT AND FINANCIAL PLANNING ADVICE FOR MEDICAL PROFESSIONALS

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At http://www.MarcinkoAssociates.com, we follow Fiduciary Standards for your protection:

Embrace the legal fiduciary obligation to place Medical colleague clients’ interests first

Deliver comprehensive financial planning and practice management advice for medical professionals

Provide fee-only advice; not fee-based advice

Do not accept commissions or assets under management

Be transparent on client costs, fees, and terms at all times

Provide transparency on portfolios and investment suggestions

Remain independent from any bank, broker dealer, insurance provider, RIA or custodian

Measure client performance returns using independent third parties

Do not create products to sell or price any public securities

Do not physically hold or possess any client assets, securities, or money for management

Investment and financial planning advice only!

OUR EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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RIP: Robert Jarvik MD; 79

BREAKING NEWS!

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Robert Jarvik, who developed the first artificial heart to be permanently implanted in a human — a breakthrough that captured the world’s imagination even as it triggered debates about medical ethics — died May 26th at his home in Manhattan, NY. He was 79.

Heart Attack: https://medicalexecutivepost.com/2021/01/08/heart-attack-symptoms/

The cause was complications from Parkinson’s disease, said his wife, writer Marilyn vos Savant.

MORE: https://en.wikipedia.org/wiki/Robert_Jarvik

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FINANCIAL LIFE PLANNING? For Physicians and Medical Professionals

SPONSOR: http://www.MarcinkoAssociates.com

By Dr. David Edward Marcinko; MBA MEd CMP

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SPONSOR: http://www.CertifiedMedicalPlanner.org

Life planning and behavioral finance as proposed for physicians and integrated by the Institute of Medical Business Advisors Inc., is unique in that it emanates from a holistic union of personal financial planning, human physiology and medical practice management, solely for the healthcare space.  Unlike pure life planning, pure financial planning, or pure management theory, it is both a quantitative and qualitative “hard and soft” science, with an ambitious economic, psychological and managerial niche value proposition never before proposed and codified, while still representing an evolving philosophy. Its’ first-mover practitioners are called Certified Medical Planners™.

Life planning, in general, has many detractors and defenders. Formally, it has been defined by Mitch Anthony, Gene R. Lawrence, AAMS, CFP© and Roy T. Diliberto, ChFC, CFP© of the Financial Life Institute, in the following trinitarian way.

Financial Life Planning is an approach to financial planning that places the history, transitions, goals, and principles of the client at the center of the planning process.  For the financial advisor or planner, the life of the client becomes the axis around which financial planning develops and evolves.

Financial Life Planning is about coming to the right answers by asking the right questions. This involves broadening the conversation beyond investment selection and asset management to exploring life issues as they relate to money.

Financial Life Planning is a process that helps advisors move their practice from financial transaction thinking, to life transition thinking. The first step is aimed to help clients “see” the connection between their financial lives and the challenges and opportunities inherent in each life transition.

But, for informed physicians, life planning’s quasi-professional and informal approach to the largely isolate disciplines of financial planning and medical practice management is inadequate. Today’s practice environment is incredibly complex, as compressed economic stress from HMOs managed care, financial insecurity from insurance companies, ACOs and VBC, Washington DC and Wall Street; liability fears from attorneys, criminal scrutiny from government agencies, and IT mischief from malicious electronic medical record [eMR] hackers. And economic bench marking from hospital employers; lost confidence from patients; and the Patient Protection and Affordable Care Act [PP-ACA] more than a decade ago. All promote “burnout” and converge to inspire a robust new financial planning approach for physicians and most all medical professionals. 

The iMBA Inc., approach to financial planning, as championed by the Certified Medical Planner™ professional certification designation program, integrates the traditional concepts of financial life planning, with the increasing complex business concepts of medical practice management. The former topics are presented in this textbook, the later in our recent companion text: The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors].

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For example, views of medical practice, personal lifestyle, investing and retirement, both what they are and how they may look in the future, are rapidly changing as the retail mentality of medicine is replaced with a wholesale and governmental philosophy. Or, how views on maximizing current practice income might be more profitably sacrificed for the potential of greater wealth upon eventual practice sale and disposition. 

Or, how the ultimate fear represented by Yale University economist Robert J. Shiller, in The New Financial Order: Risk in the 21st Century, warns that the risk for choosing the wrong profession or specialty, might render physicians obsolete by technological changes, managed care systems or fiscally unsound demographics. OR, if a medical degree is even needed for future physicians?

Say, what medical license?

Dr. Shirley Svorny, chair of the economics department at California State University, Northridge, holds a PhD in economics from UCLA. She is an expert on the regulation of health care professionals who participated in health policy summits organized by Cato and the Texas Public Policy Foundation. She argues that medical licensure not only fails to protect patients from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible. Institutional oversight and a sophisticated network of private accrediting and certification organizations, all motivated by the need to protect reputations and avoid legal liability, offer whatever consumer protections exist today.

Yet, the opportunity to revise the future at any age through personal re-engineering, exists for all of us, and allows a joint exploration of the meaning and purpose in life. To allow this deeper and more realistic approach, the informed transformation advisor and the doctor client, must build relationships based on trust, greater self-knowledge and true medical business management and personal financial planning acumen.

[A] The iMBA Philosophy

As you read this ME-P website, we hope you will embrace the opportunity to receive the focused and best thinking of some very smart people. Hopefully, along the way you will self-saturate with concrete information that proves valuable in your own medical practice and personal money journey. Maybe, you will even learn something that is so valuable and so powerful, that future reflection will reveal it to be of critical importance to your life.  The contributing authors certainly hope so.

At the Institute of Medical Business Advisors, and thru the Certified Medical Planner™ program, we suggest that such an epiphany can be realized only if you have extraordinary clarity regarding your personal, economic and [financial advisory or medical] practice goals, your money, and your relationship with it. Money is, after only, no more or less than what we make of it. 

Ultimately, your relationship with it, and to others, is the most important component of how well it will serve you. 

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com 

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MEDICINE: Flat Fee Per Patient Treatment Case

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Flat Fee-Per-Case

Classic: Flat fee paid for a patient’s treatment based on their diagnosis and/or presenting problem. For this fee the provider covers all of the services required for a specific period of time.

PHYSICIAN SALARY: https://medicalexecutivepost.com/2023/04/14/physician-salary-pay-gap/

Modern: Often characterizes “second generation” managed care systems. After a Managed Care Organization squeezes out costs by discounting fees, they often come to this method. If provider is still standing after discount blitz, this approach can be good for provider and clients, since it permits a lot of flexibility for provider in meeting client needs.

PHYSICIAN NET WORTH: https://medicalexecutivepost.com/2024/09/21/physician-net-worth-personalized-projections/

Example: A Flat fee system paid for a medical treatment based on a patient’s diagnosis for a specific period of time.

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EDUCATION: Books

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PHYSICIANS: Personal Portfolio Management?

BY DR. DAVID EDWARD MARCINKO; MBA MEd CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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SPONSOR: http://www.MarcinkoAssociates.com

Most individual physician portfolios are simply a list of stocks.  Doctors with such lists usually know the cost of each position and when they acquired it.  It is not unusual to find inherited low cost stocks in the account that have been held for many years.

When you inherit securities, a new cost basis is established (the price of the stock on the date of death or six months later—the executor of the estate makes this determination). Even though there would be no capital gain liability if the stock were sold immediately after date of death, most people simply don’t do anything, just hold the stock. Of course taxes should be considered when selling securities but the investment merit should be the overriding factor. 

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Doctor and Accountant Opinions

In a personal communication, Mr. L. Eddie Dutton, CPA said, “First make an investment decision and if it fits into the tax plan, so much the better.  Doctors often wonder where they will get the money to pay the taxes.  I say to get it from the sale of the appreciated stock and cry all the way to the bank with your profit.”

Dr. Ernest Duty MD, a very successful private investor advises “Ask yourself this question: If you had the money instead of the stock, would you buy the stock?  If your answer is ‘Yes’ then, hold on to the stock but if you say ‘No, I wouldn’t buy that stock today’ then, sell it” [personal communication].

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: E-MAIL CONTACT: MarcinkoAdvisors@outlook.com 

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GIVING CIRCLES: Defined

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Giving circles are kick starting a new era of philanthropy where individuals give together to make social change happen.

A giving circle brings a group of people with shared values together to collectively discuss and decide where to make a pooled gift.

Philanthropy: https://medicalexecutivepost.com/2021/11/15/national-philanthropy-day-2021/

Giving circles support with their dollars, but also build awareness, volunteer, become board members and more. Individuals multiply their impact and knowledge, have fun, and connect with their local community.

Ethics: https://medicalexecutivepost.com/2024/06/22/medical-ethics-managing-risk-is-a-component-of-caring/

People are coming together around the world to create the change they want to see in the world. Giving circles are a growing global movement with more than 2,500 active circles around the world giving intentionally and thoughtfully.

Donor Advised Funds: https://medicalexecutivepost.com/2024/11/27/a-thanksgiving-donation-in-name-only/

Giving circles are a modern form of collective giving with roots in cultures across the globe for many decades!

EDUCATION: Books

Cite: https://johnsoncenter.org/2023-us-collective-giving-research-initiative/

Visit WhatIsAGivingCircle.com for more on this collective giving model and why people-centered philanthropy is so powerful.

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