DAILY UPDATE: Physician Salary, Consumer Confidence, Company Stocks and Slumping Markets

Posted on May 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

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Doctors Saw a 6% Boost in Pay in 2023

After several years of modest or declining growth, the average pay for doctors jumped 5.9% in 2023, rebounding from a decline of 2.4% in 2022. Most medical specialties experienced positive growth in 2023, with the top 10 seeing annual growth rates exceeding 7%, according to the 2024 Physician Compensation Report from professional medical network Doximity.

However, inflationary pressures continue to impact physicians’ real income. According to the American Medical Association, when adjusted for inflation, Medicare physician payment has dropped 26% since 2001. Doximity’s compensation data draw from nearly 150,000 survey responses over five years, including responses from more than 33,000 U.S. physicians in 2023 alone.

Source: Heather Landi, Fierce Healthcare [5/23/24]

Economic Summary

  • The S&P 500 has risen 23 of the last 30 weeks, according to Deutsche Bank, and rose slightly today as well. Meanwhile, the NASDAQ closed at a record high yesterday after tech companies across the board rose, while the Dow dropped over 200 points.
  • Treasury prices fell and yields rose after two weaker-than-expected auctions saw soft sales of 2-year and 5-year bonds.
  • Gold prices slipped 5% last week after falling four days in a row, but the key commodity kicked off this week with a win. With key PCE data coming out on Friday that could send the market soaring or tanking, investors are hedging their bets with the shiny yellow metal.
  • Bitcoin fell as Mt. Gox made good with its creditors a decade after being hacked, while ethereum sank as traders continued to lock in gains from the SEC’s dramatic ruling last week.
  • The S&P 500® index (SPX) fell 39.09 points (0.7%) to 5,266.95; the Dow Jones Industrial Average lost 411.32 points (1.1%) to 38,441.54; the NASDAQ Composite® ($COMP) shed 99.30 points (0.6%) to 16,920.58.
  • The 10-year Treasury note yield climbed more than 7 basis points to 4.614%.
  • The CBOE Volatility Index® (VIX) rose 1.38 to 14.30.

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Consumer confidence rose for the first time in four months

Americans are unexpectedly feeling better about the economy this month: Per the Conference Board’s monthly index, US consumer sentiment rose from 97.5 in April to 102 in May, smashing economists’ estimates. Meanwhile, the expectations index, which measures the short-term outlook for income and other labor market conditions, increased the most since July. However, the report showed that Americans remain worried about inflation and interest rates. Despite their mixed feelings about the economy, Americans continue to spend vigorously on travel. The TSA set a record for most travelers screened in a single day last Friday.

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STOCKS UP:

Dick’s Sporting Goods rose 15.86% to a new all-time high today after the company reported impressive earnings and a strong outlook.

STOCKS DOWN:

American Airlines shares fell 13.54% after the company cut its guidance for the second quarter. Southwest Airlines fell 3.83%, and Delta Air Lines fell 0.74%.

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DAILY UPDATE: Deutsche Bank, YouTube Health Initiative and the Markets

Posted on July 22, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Regulators fined Deutsche Bank $186 million for not fixing anti-money laundering, due diligence, and sanctions controls. This is the third time since 2015 that the Federal Reserve has fined the troubled bank for internal control failures. (CNN Business)

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Under the YouTube Health Initiative, the company partnered with several healthcare organizations, including traditional health systems like Cleveland Clinic in Ohio and Mass General Brigham in Boston, as well as online health education platforms like Osmosis and Psych Hub. Other partners include the medical journal the New England Journal of Medicine, the World Health Organization, and the American Public Health Association.

These health organizations created videos on a range of health topics, which YouTube curates in what it calls “carousels” and labels to indicate that the information comes from reputable sources. If someone searches for information on diabetes, for example, they’ll get a carousel of videos from the health partners on diabetes.

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Here is where the major benchmarks ended yesterday and for the week:

  • The S&P 500 Index was up 1.47 points at 4,536.34, up 0.7% for the week and the benchmark’s eighth weekly gain in the past 10; the Dow Jones industrial average was up 2.51 points at 35,227.69, up 2.1% for the week; the NASDAQ Composite was down 30.50 points (0.2%) at 14,032.81, down 0.6% for the week.
  • The 10-year Treasury note yield (TNX) was down about 2 basis points at 3.837%.
  • CBOE’s Volatility Index (VIX) was down 0.39 at 13.60.

Utility and health care shares were among the strongest performers Friday, which may reflect investors rotating into more “defensive” sectors, which haven’t participated as much in this year’s rally and may be seen as a “relative value” or “catch-up” play.

Energy stocks were also strong as crude oil futures jumped over 2% and posted a fourth straight weekly gain. Regional banks and communication services were among the weakest sectors, while the small-cap-focused Russell 2000 (RUT) fell slightly.

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DAILY UPDATE: Jack Dorsey, Deutsche Bank and the Markets

Posted on March 25, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Short seller Hindenburg Research has hit another billionaire’s fortune with a report. Jack Dorsey, the co-founder of payments company Block and Twitter, saw his net worth tumble by $526 million, or 11%, to $4.4 billion after the US-based research firm led by Nathan Anderson accused Block of misleading investors in a March 23 report, according to Bloomberg. Dorsey isn’t on the list of the world’s 500 richest persons on the Bloomberg Billionaires Index currently. He was previously featured at number 456 with a net worth of $5.41 billion on March 22nd, per Insider’s scan of the Index on Wednesday.

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Investors sparked a furious selloff in Deutsche Bank AG and thrust one of Europe’s most important lenders into the center of concerns about the health of the global financial system. Shares of Germany’s largest lender tumbled as much as 15%, their third consecutive day of losses, though they later regained some ground and were recently down 10%. The cost to insure against its default using credit-default swaps soared to their highest levels since 2020.

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Chairman Jerome Powell was ambiguous this week about future Federal Reserve moves, suggesting “some additional policy firming may be needed.”

Treasury yields dropped near seven-month lows, a seeming indication of escalating recession worries after the Fed raised its benchmark lending rate nine times to a range of 4.75% to 5% over the past year. The release next week of updated data on consumer confidence, inflation, and economic growth will likely be in focus.

Monetary Policy: https://medicalexecutivepost.com/2023/03/17/the-modern-us-monetary-system/

The swings in stock prices this week “were consistent with the unclear outlook for monetary policy, the banking system, and the broader economy,” says Kevin Gordon, senior investment strategist at Charles Schwab. “More time needs to pass before we know the true impact of the expected tightening in credit conditions.”

  • The S&P 500® Index was up 22.27 (0.6%) at 3970.99; the Dow Jones industrial average was up 132.28 (0.4%) at 32,237.53; the NASDAQ Composite was up 36.56 (0.3%) at 11,823.96.
  • The 10-year Treasury yield was little changed at about 3.374%.
  • CBOE’s Volatility Index was down 0.87 at 21.74.

The real estate sector led the gainers Friday, followed by consumer staples and health care. Financials and consumer discretionary stocks edged lower, and technology stocks were little changed, though the tech-focused NASDAQ Composite still notched its second straight weekly gain. Gold and crude oil futures both declined, while the U.S. dollar strengthened.

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“Sell Everything!”

Posted on February 13, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

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Rick Kahler MS CFP

[By Rick Kahler MS CFP]

“Sell Everything!”

That’s the advice to investors from RBS, a large investment bank based in Scotland, which issued the dire recommendation to its customers on January 8th, 2016.

The warning urged investors to sell everything except high-quality bonds, predicting the global economy was in for a “fairly cataclysmic year ahead …. similar to 2008.” They said this is a year to focus on the return of capital rather a return on capital.

Stunning

I was first stunned that a respectable investment bank would issue such a radical recommendation. Then I was amused at my own surprise. I had momentarily forgotten this is logical behavior for a company whose profits depend on its customers actively buying and selling. It is not legally required to look out for customers’ best interests and has no incentive to do so.

Clearly, the time-honored way of earning market returns over the long haul is to diversify among asset classes, rebalance religiously, and always stay in the markets. The research is overwhelming that shows those who attempt to time the markets have significantly lower returns over the long haul than those who don’t.

Example:

For example, according to a study by Dalbar, Inc., over the last twenty years the average underperformance of investors and advisors that timed the market was 7.12% a year.

What’s so bad about trying to minimize loses and selling out when things begin looking scary?

Nothing. Who wouldn’t want to exit markets just in time to watch them fall so low that you could sweep up bargains by buying back in? Therein lies the problem: not only do you need to get out on time (not too early and not too late), but you must then know when to get back in.

The Crystal Ball

The only way I know to do this is to own a crystal ball, which the economists at RBS apparently possess.

Here are a few of the things they say to expect:

  • Oil could fall as low as $16 a barrel.
  • The world has far too much debt to be able to grow well.
  • Advances in technology and automation will wipe out up to half of all jobs.
  • Global disinflation is turning to global deflation as China and the US sharply devalue their currencies.
  • Stocks could fall 10% to 20%.

Prediction

The last prediction was the one that grabbed my attention. Given the comparison of the coming year to 2008, I expected a forecast of a significantly greater drop in stocks, say 40% to 60%. Comparatively, their forecast of 10% to 20% seems almost rosy.

While RBS is particularly gloomy, bearish forecasts have also been issued by other investment brokerage firms, including JP Morgan, Morgan Stanley, Bank of America Merrill Lynch, Barclays, Deutsche Bank, Societe Generale, and Macquarie.

Just for perspective, here’s a look as reported by The Spectator at previous predictions from Andrew Roberts, the RBS analyst who issued the recent dire warning. In June 2010, he warned,

“We cannot stress enough how strongly we believe that a cliff-edge may be around the corner, for the global banking system (particularly in Europe) and for the global economy. Think the unthinkable.” In July 2012, he said, “People talk about recovery, but to me we are in a much worse shape than the Great Depression.”

Incidentally, one thing Roberts did not predict was the meltdown of 2008.

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“Sell Everything?”

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Assessment

The inaccuracy of earlier dire predictions should encourage physicians and all investors to stay the course.

As usual, chances are that those who diversify their investments among five or more asset classes and periodically rebalance their portfolios will come out on top. The odds greatly favor consumers who ignore doom-and-gloom warnings, especially from those whose companies may profit from investor panic.

Conclusion

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Beware Medical and Money Management ‘Groupthink’

Posted on July 5, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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Helping Doctors Understand Peer Comparisons

By J. Wayne Firebaugh CPA, CFP® CMP™

By Dr. David E. Marcinko MBA, CMP™

Source: http://www.CertifiedMedicalPlanner.org

More than a few mutual, hedge and endowment fund managers have noted that they commonly compare their endowment and portfolio allocations to those of peer institutions and that as a result, allocations are often similar to the “average” as reported by one or more surveys/consulting firms.

One interviewed endowment fund manager expanded this thought by presciently noting that expecting materially different performance with substantially the same allocation is unreasonable. It is anecdotally interesting to wonder whether any “seminal” study “proving” the importance of asset allocation could have even had a substantially different conclusion. It seems likely that the pensions and funds surveyed in these types of studies have very similar allocations given the human tendency to measure one-self against peers and to use peers for guidance.

This is a truism in medicine as well as the financial services sector.

Understanding Peer Comparisons

Although peer comparisons can be useful in evaluating your portfolio, or your hospital or medical practice’s own processes, groupthink can be highly contagious and dangerous.

For historical example, in the first quarter of 2000, net flows into equity mutual funds were $140.4 billion as compared to net inflows of $187.7 billion for all of 1999. February’s equity fund inflows were a staggering $55.6 billion, the record for single month investments. For all of 1999, total net mutual fund investments were $169.8 billion[1] meaning that investors “rebalanced” out of asset classes such as bonds just in time for the market’s March 24, 2000 peak (as measured by the S&P 500).

Of course, physicians and investors are not immune to poor decision making in upward trending markets. In 2001, investors withdrew a then-record amount of $30 billion[2] in September, presumably in response to the September 11th terrorist attacks. These investors managed to skillfully “rebalance” their ways out of markets that declined approximately 11.5% during the first several trading sessions after the market reopened, only to reach September 10th levels again after only 19 trading days. In 2002, investors revealed their relentless pursuit of self-destruction when they withdrew a net $27.7 billion from equity funds[3] just before the S&P 500’s 29.9% 2003 growth.

Amateurs versus Professionals [is there such a thing?]

Although it is easy to dismiss the travails of mutual fund investors as representing only the performance of amateurs, it is important to remember that institutions are not automatically immune by virtue of being managed by investment professionals.

For example, in the 1960s and early 1970s, common wisdom stipulated that portfolios include the Nifty Fifty stocks that were viewed to be complete companies.  These stocks were considered “one-decision” stocks for which the only decision was how much to buy. Even institutions got caught up in purchasing such current corporate stalwarts as Joe Schlitz Brewing, Simplicity Patterns, and Louisiana Home & Exploration.  Collective market groupthink pushed these stocks to such prices that Price Earnings ratios routinely exceeded 50 [nothing in the internet age]. Subsequent disappointing performance of this strategy only revealed that common wisdom is often neither common nor wisdom.

The Bear Sterns Example

Recall that The New York Times reported on June 21, 2007, that Bear Stearns had managed to forestall the demise of the Bear Stearns High Grade Structured Credit Strategies and the related Enhanced Leveraged Fund.  The two funds held mortgage-backed debt securities of almost $2 billion many of which were in the sub-prime market.  To compound the problem, the funds borrowed much of the money used to purchase these securities.  The firms who had provided the loans to make these purchases represented some of the smartest names on Wall Street, including JP Morgan, Goldman Sachs, Bank of America, Merrill Lynch, and Deutsche Bank.[4]  Despite its efforts Bear Stearns had to inform investors less than a week later on June 27 that these two funds had collapsed. The subsequent fate of these firms, and the history of the past two years, need not be repeated to appreciate that the king surely had no clothes.

Assessment

What broader message lies in this post relative to such medical initiatives as P4P, various clinical quality improvement endeavors and benchmarks, hospital peer-review, PROs, Medicare compliance, etc?  

Conclusion

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References

[1]   2001 Fact Book, Investment Company Institute.

[2]   Id.

[3]   2003 Fact Book, Investment Company Institute.

[4]    Bajaj, Vikas and Creswell, Julie. “Bear Stearns Staves off Collapse of 2 Hedge Funds.” New York Times, June 21, 2007.

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Bank Deals Similar to Goldman Sach’s Gone Awry

Posted on April 21, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Other Major Banks Participated, Too?

By Marian Wang, ProPublica – April 16, 2010 1:36 pm EDT

As you may have heard, or read on this ME-P, Goldman Sachs is being sued for fraud [1] by the Securities and Exchange Commission [2] for allegedly misleading investors about a deal that Goldman helped structure and sell. In the civil suit, the SEC specifically faulted Goldman for failing to disclose that a hedge fund was helping create the investment while betting big the deal would fail.

According to the SEC, Goldman Sachs knew about the hedge fund’s bets, knew it played a significant role in choosing the assets in the portfolio, and yet did not tell investors about it. (Goldman Sachs has called the SEC’s accusations “completely unfounded in law and fact.” And in another more detailed statement [3], it said it “did not structure a portfolio that was designed to lose money.”) 

[picapp align=”none” wrap=”false” link=”term=Goldman+Sachs&iid=8541566″ src=”0/4/f/8/The_Goldman_Sachs_7d6f.jpg?adImageId=12513388&imageId=8541566″ width=”380″ height=”568″ /]

In ProPublica

As we reported at ProPublica last week, many other major investment banks were doing a similar thing [4].

Investment banks including JPMorgan Chase [5], Merrill Lynch [6] (now part of Bank of America), Citigroup, Deutsche Bank and UBS also created CDOs that a hedge fund named Magnetar was both helping create and betting would fail. Those investment banks marketed and sold the CDOs to investors without disclosing Magnetar’s role or the hedge fund’s interests.

Here is a list of the banks that were involved [7] in Magnetar deals, along with links to many of the prospectuses on the deals, which skip over Magnetar’s role. In all, investment banks created at least 30 CDOs with Magnetar, worth roughly $40 billion overall. Goldman’s 25 Abacus CDOs — one of which is the basis of the SEC’s lawsuit — amounted to $10.9 billion [8].

One reporter Jake Bernstein explained the investment banks’ disclosure failures on Chicago Public Radio’s This American Life [9]:

On the Magnetar Hedge Fund

The role of Magnetar, both as equity investor and in their bets against the very CDOs they helped create were not disclosed in any way to investors in the written documents about the deals. Not the marketing materials, not the prospectuses, not in the hundreds of pages that an investor could get to see information about the deal was it disclosed that it was in fact Magnetar who’d helped create the deal, and who’d bet against.

That is, of course, along the lines of what the SEC is suing Goldman Sachs for now. The SEC’s suit also says CDOs like the ones Goldman built “contributed to the recent financial crisis by magnifying losses associated with the downturn in the United States housing market.”

Notably, the SEC did not sue the hedge fund [10] involved in Goldman’s Abacus deals — Paulson & Co. — or its manager, John Paulson. Instead, it’s going after Goldman. And as we pointed out in our reporting, there’s no evidence that what Magentar did was illegal [11].

Assessment

We’ve called the major banks involved in Magnetar CDO deals to see if they were concerned about similar lawsuits. Thus far, Bank of America, Citigroup, Deutsche, Wells Fargo (which bought Wachovia) and UBS have responded and have all declined our requests for comment. Here is Magnetar’s response [12] to our original reporting.

Conclusion

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