BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on October 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Chip stocks recovered lost ground today thanks to a strong earnings report from TSMC (more on that below). Nvidia led the group higher, rising 0.89% to yet another new all-time high.
Blackstone rose 6.30% to a new record high after the world’s largest alternative asset manager reported an excellent quarter.
Expedia popped 4.75% after a report by the Financial Times revealed that Uber had explored an acquisition of the travel site. Expedia shareholders cheered the news, while Uber shares sank 2.45%.
Stocks Down
Robinhood fell 2.27% after announcing its new Legend trading platform geared specifically toward advanced traders.
Lucid Group plummeted 17.99% on the news that the EV automaker is offering over 262 million shares of its common stock in an attempt to raise funds.
CSX dropped 6.71% after missing both top- and bottom-line estimates last quarter thanks in no small part to hurricanes Helene and Milton.
Health insurance stocks took a beating today due to a not-great earnings report from ElevanceHealth (more on that below, too). Centene Corp. fell 9.09%, while Molina Healthcare tumbled 12.55%.
The S&P 500® index (SPX) slipped 1.00point (–0.02%) to 5,841.47; the $DJI added 161.35 points (0.37%) to 43,239.05; and the NASDAQ Composite®($COMP) rose 6.53 points (0.04%) to 18,373.61.
The 10-year Treasury note yield (TNX) climbed eight basis points to 4.1%.
The CBOE Volatility Index® (VIX) sank to 18.97 by late Thursday, a two-week low.
The average amount owed on “upside down” auto loans, in which the balance is more than the car is worth, hit a record high of $6,458 in the third quarter, according to Edmunds, a site that helps consumers research and buy cars
Posted on October 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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By Vitaliy N. Katsenelson, CFA
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EDITOR’S NOTE: In this interview with investment website @GuruFocus, my colleague Vitaliy shares the full gamut of how he invests, where and why. He touches on the role of being eclectic when investing, how to invest abroad, and how value investors should think about macro-economics and finance, among many other important topics. Enjoy this fun and wide-ranging interview!
Posted on October 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Goldman Sachs’ profit jumped 45% in monster quarter. The investment bank made $3 billion of profit on revenue of nearly $13 billion in Q3, it reported yesterday, surpassing even the rosiest of expectations. Bloomberg reported that it was the best quarter ever for Goldman’s stock trading unit, putting the group on track for a record year.
Walgreenssaid it will close 1,200 US stores, about one in seven locations, by 2027. The retailer will shutter 500 stores by the end of next year.
Trump Media & Technology Group has had a wild week, falling nearly 10% yesterday before trading of the stock was halted, then popping 15.52% today. Election hype, a Trump-sponsored cryptocurrency, and Truth+, a new streaming service, are keeping shareholders on their toes.
Abbott Laboratories rose 1.53% thanks to a stronger-than-expected earnings report powered by the company’s impressive medical device sales.
Aspen Aerogels makes insulating material for batteries, which sounds boring to everyone but the Department of Energy. The DOE signed a conditional commitment to loan the company up to $670 million, sending shares 13.24% higher.
DOWN STOCKS
Novavax plummeted 19.44% after the FDA put a hold on the pharma company’s flu and Covid vaccine combination.
Interactive Brokers enjoyed higher revenue and more trading from its user base last quarter, but earnings per share came in under expectations, and shares sank 4.05%.
The SPX rose27.21points (0.47%) to 5,842.47; the Dow Jones Industrial Average® ($DJI) added 337.28 points (0.79%) to 43,077.70; and the NASDAQ Composite®($COMP) increased 51.49 points (0.28%) to 18.367.08.
The 10-year Treasury note yield (TNX) fell two basis points to just below 4.02%, the lowest close since October 4.
The CBOE Volatility Index® (VIX) dropped moderately to 19.58, still elevated considering stock market strength.
Posted on October 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Maximum lifespans. The upper limit of human life expectancy is leveling out, according to a new study published in the journal Nature Aging. Back in 1990, life-extending tech and health measures were increasing the average global lifespan by about 2.5 years per decade, but that dropped to 1.5 years per decade in the 2010s and closer to zero in the US, where there are more drug overdoses, shootings, and medical care inequities.
Stocks kicked off the first full week of earnings season at full throttle. The S&P 500 rose to a new intraday record, the Dow closed above 43,000 for the first time ever, and the NASDAQ climbed steadily throughout the trading session.
Bitcoin soared on the news of China’s additional stimulus spending that broke this weekend. Although the Chinese government’s plans are light on details at the moment, the promise of more support for the world’s second largest economy was enough to get crypto traders hyped.
Interestingly enough, those same promises of Chinese stimulus sent oil tumbling to start the day. The selling was exacerbated by OPEC’s announcement that crude demand will fall lower than expected in 2024 and 2025.
Gold sank a hair today as traders weighed Chinese stimulus against a stronger dollar.
The S&P 500® index (SPX) rose44.82points (0.77%) to 5,859.85, a new closing high; the Dow Jones Industrial Average® ($DJI) increased 201.36 points (0.47%) to 43,065.22, also a new closing high; and the NASDAQ Composite®($COMP) added 159.74 points (0.87%) to 18,502.69.
The 10-year Treasury note yield (TNX) did not trade today due to the holiday.
The CBOE Volatility Index® (VIX) slipped to 19.9, its first drop below 20 since October 4.
A slate of corporate earnings reports coming from Goldman Sachs, Bank of America, and Citigroup in the financial sector, along with healthcare giants Johnson & Johnson, Walgreens, and UnitedHealth. And throughout the week: Morgan Stanley will report on Wednesday, Netflix reports on Thursday, and Procter & Gamble and American Express drop their financials on Friday. It’ll pose a big test for the stock market’s $8 trillion rally this year.
Posted on October 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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U.S. stock markets, including the New York Stock Exchange and the NASDAQ remain open and follow a regular schedule today.
The bond markets will be closed, however.
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Stocks ended last week on a high note, closing out their fifth straight week of gains. The Dow was pushed to yet another new all-time high by strong earnings from JPMorgan, while the S&P 500 was in the green and rose to its own record close, and the NASDAQ clawed its way out of the red by early Friday afternoon.
Bond yields took a breather, falling below 4.1% thanks to a better-than-expected PPI report that helped offset inflation fears that had re-arisen after a worse-than-expected CPI report.
Gold rose as well on PPI news, since the data pointed to a better chance of more rate cuts ahead.
Oil fell a bit but gained over the last two weeks on geopolitical tensions and destruction in the Gulf of Mexico following the two major hurricanes.
According to colleague Dan Ariely PhD, a Zero Sum Bias [ZSB] is the mistaken belief that one person’s gain is another’s loss. It’s like thinking the world is a giant pie with only so many slices. This mindset fuels competition and jealousy, making us forget that collaboration can create more pie. It’s why we sometimes root against others instead of working together.
Question: Is the stock market a zero-sum game? You frequently hear media refer to games and markets as zero-sum games.
Answer: Well, yes, we define the stock market as a zero-sum game, both in the short and in the long term, although it technically is incorrect. A zero-sum game is where one person’s gain is another person’s loss – thus there is no wealth created and the overall benefit is zero. This doesn’t apply to stocks, but it’s a zero-sum game in relation to a stock market benchmark.
For example, short-term trading in stocks is theoretically not a zero-sum game, and neither is long-term investing. But short-term trading is close to a zero-sum game, and long-term investing is a zero-sum game if we use a broad index as a benchmark.
Essentially, in other words, the stock market functions as an expansive network of zero-sum transactions; each trade engages a buyer and a seller–their perspectives on a security’s future value contrasting. These opposing views propel market prices: they mirror not only risk transfer but also potential reward—a dynamic process indeed! Traders and investors must grasp the crucial zero-sum aspect; it underscores trading’s inherent competitiveness. Effectively anticipating market trends and actions from other participants: therein lies success in this environment.
Posted on October 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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October continues to be a tough month for stocks, with all three major indexes spending yesterday afternoon in the red. The Dow in particular had a horrible day and dropped over 500 points, while major tech stocks were pushed lower by a series of analyst downgrades.
Oil continued its hot streak yesterday, rising above $77 on the back of geopolitical conflict in the Middle East. That helped ensure that, while everything else fell, energy was the only positive sector in the S&P 500.
Gold has often found itself rising in tandem with crude, though it broke that habit, with the shiny safe haven dropping a hair as investors digest the idea that the Fed’s next interest rate cut may be smaller than they thought.
Bitcoin broke above $64,000 for a moment yesterday only to be yanked back down, as crypto traders ride out the recent volatility.
Posted on October 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
IN PRIVATE EQUITY AND MEDICINE
By Staff Reporters
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PRIVATE EQUITY
In private equity, the J curve is used to illustrate the historical tendency of private equity funds to deliver negative returns in early years and investment gains in the outlying years as the portfolios of companies mature.
And, according to Wikipedia, in the early years of the fund, a number of factors contribute to negative returns including management fees, investment costs and under-performing investments that are identified early and written down. Over time the fund will begin to experience unrealized gains followed eventually by events in which gains are realized (e.g., IPOs, mergers and acquisitions, leveraged recapitalizations).
Historically, the J curve effect has been more pronounced in the US, where private equity firms tend to carry their investments at the lower of market value or investment cost and have been more aggressive in writing down investments than in writing up investments. As a result, the carrying value of any investment that is under performing will be written down but the carrying value of investments that are performing well tend to be recognized only when there is some kind of event that forces the PE to mark up the investment.
The steeper the positive part of the J curve, the quicker cash is returned to investors. A private equity firm that can make quick returns to investors provides investors with the opportunity to reinvest that cash elsewhere. Of course, with a tightening of credit markets, private equity firms have found it harder to sell businesses they previously invested in. Proceeds to investors have reduced. J curves have flattened dramatically. This leaves investors with less cash flow to invest elsewhere, such as in other private equity firms. The implications for private equity could well be severe. Being unable to sell businesses to generate proceeds and fees means some in the industry have predicted consolidation among private equity firms.
MEDICINE
In medicine, the “J curve” refers to a graph in which the x-axis measures either of two treatable symptoms (blood pressure or blood cholesterol level) while the y-axis measures the chance that a patient will develop cardiovascular disease (CVD). It is well known that high blood pressure or high cholesterol levels increase a patient’s risk.
Paradoxically, what is less well known is that plots of large populations against CVD mortality often take the shape of a J curve which indicates that patients with very low blood pressure and/or low cholesterol levels are also at increased risk.
Posted on October 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Costco, which found success selling gold bars, will now sell platinum ones, too.
US dock workers agreed to return to work after port operators sweetened their contract offer, ending a three-day strike that threatened to disrupt the American economy. The breakthrough Thursday came after port employers offered a 62% increase in wages over six years, according to people familiar with the matter.
Nvidia gained 3.32% after CEO Jensen Huang said in an interview that demand for the company’s new Blackwell chips is “insane.”
EVgo soared 60.81% after the EV charging company received both a $1.05 billion loan from the Department of Energy and an upgrade from JP Morgan analysts.
Utility stocks soared in the third quarter thanks to higher electricity demand for AI, and it isn’t stopping anytime soon. Both Vistra Corp. and Constellation Energy surged 5.62% and 4.52%, respectively, on comments from Google CEO Sundar Pichai that the tech titan may utilize nuclear energy in the coming years.
Stocks down
Levi Strauss sank 7.69% after releasing subpar earnings, cutting its full-year sales forecast , and announcing it may sell its Dockers brand.
Hims & Hers Health dropped 9.60% on the announcement that Eli Lilly’s weight-loss drugs are no longer on the FDA’s shortage list.
Joby Aviation tumbled 8.63%, giving up a portion of yesterday’s gains after the aviation startup received $500 million in additional funding from Toyota.
Stellantis, makers of Jeep, Dodge, and Chrysler vehicles, sank 4.11% to a new 52-week low today as a combination of terrible sales forecasts and a downgrade from Barclays analysts kicked the automaker while it’s already down.
Constellation Brands had strong beer sales but terrible wine and spirits sales last quarter, leading to a mixed earnings report that has shareholders worried about what the future holds. Shares sank 4.70%.
The S&P 500® index (SPX)fell 10 points (–0.17%) to 5,699.96; the Dow Jones Industrial Average ($DJI) dropped 185 points (–0.44%) to 42,011.59; the NASDAQ Composite® ($COMP) shed 7 points (–0.04%) to 17,918.48.
The 10-year Treasury note yield (TNX) added 7 basis points to 3.85%.
The CBOE Volatility Index® (VIX) rose 1.7 points to 20.59.
Posted on October 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Rosh Hashanah, the Jewish New Year, begins tonight and ends on Friday. Shana Tova to those celebrating.
Microsoft overhauled its Copilot AI assistant, adding voice and vision capabilities to make it more personalized.
A new report from Deloitte reveals improving health equity could increase the country’s GDP by $2.8 trillion by 2040 and increase U.S.-based corporate profits by $763 billion.
And … Johnson & Johnson’s is not moving forward with implementation of its proposed rebate model after HRSA push-back.
Caesars Entertainment popped 5.27% after it announced it will buy back $500 million in common shares while also offering $1 billion in senior notes to raise money.
Joby Aviation surged 27.92% on the news that Toyota will invest another $500 million in the aviation startup as it attempts to build a flying electric taxi.
Lamb Weston Holdings rose 2.62% thanks to a strong earnings report and a comprehensive restructuring plan for the french fry titan.
Novavax soared 19.16% following a glowing report from Jefferies analysts citing the pharma company’s strong vaccine sales.
What’s down stocks
Tesla sank 3.49% after revealing that auto deliveries for the third quarter came in lower than analysts expected.
Ford fell 2.51% for pretty much the same reason, reporting disappointing sales growth in the third quarter.
It’s never a good thing when a company pulls its guidance, and that was certainly true for Nike today. Shares dropped 6.77% after the company postponed its investor day and reported a 10% year over year decline in sales.
Nike’s report was so bad that shares of Foot Locker and Dick’s Sporting Goods fell 2.97% and 0.23%, respectively.
Humana plummeted 11.79% on the news that membership in its 4 star-rated Medicare Advantage plans plunged 94%.
Conagra Brands dropped 8.07% after the packaged food giant missed on both sales and earnings estimates last quarter.
The S&P 500® index (SPX)was little changed at 5,709.54; the Dow Jones Industrial Average ($DJI) rose 39.55 points (0.09%) to 42,196.52; the NASDAQ Composite® ($COMP) gained 14.76 points (0.08%) to 17,925.12.
The 10-year Treasury note yield (TNX) added 5 basis points to 3.78%.
The CBOE Volatility Index® (VIX) edged 0.4 points lower to 18.86.
CVS is laying off nearly 3,000. The healthcare giant is conducting a strategic review as its stock has fallen more than 20% this year, the Wall Street Journal reported
Posted on October 1, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Despite inflation cooling down, employer health plan costs are heating up, according to a September analysis from consulting firm consulting firm Mercer.
CVS popped 2.38% after the Wall Street Journal reported that major shareholder Glenview Capital Management will meet with company executives to discuss potential strategies to improve the sagging stock.
Nio drove 2.45% higher thanks to a $2 billion cash injection from key shareholders into the Chinese EV company.
STOCKS DOWN
Stellantis, the European company behind Chrysler, Dodge, and Jeep sank 12.49% after it warned that sales in the second half of its fiscal year will come in lower than expected. The bad news pulled down shares of competitors Aston Martin (which fell 24.51%), Ford (a 2% drop),and GM (3.53% lower today).
Carnival beat top and bottom line estimates last quarter, and posted record revenue for the third quarter. But shares stumbled 0.32% on management’s forecast that earnings in the fourth quarter will disappoint. Rival cruise companies all dropped in sympathy: Royal Caribbean fell 0.10%, while Norwegian Cruise Line Holdings tumbled 2.10%.
Here’s where the major stock market benchmarks ended:
The SPX gained 24.26 points (0.42%) to 5,762.48; the Dow Jones Industrial Average® ($DJI) rose 17.15 points (0.04%) to 42,330.15; the NASDAQ Composite® ($COMP) added 69.58 points (0.38%) to 18,189.17.
The 10-year Treasury note yield (TNX) climbed five basis points to 3.8%, near the high of its recent range.
The CBOE Volatility Index® (VIX) eased to 16.66 after climbing above 17 earlier today but remains up from a week ago.
Posted on September 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Markets: It’s been a September to remember for the stock market after the S&P 500 and Dow Jones hit fresh highs last week. Thursday was the 42nd record-high close for the S&P 500 this year, and on Friday, the Dow notched its 32nd record-high close, per CNN Business. Recent data indicates that all the ingredients are coming together for a “soft landing”: The economy is staying strong while inflation has continued to fall. And more rate cuts are on their way.
Stock spotlight: Meta’s rally this year has been fruitful for its CEO’s bank account. The net worth of Mark Zuckerberg, who owns a 13% stake in his company, climbed above $200 billion for the first time, per Bloomberg. He’s now the fourth-richest person in the world.
Posted on September 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS
By Staff Reporters
Tropical Storm Helene made landfall in Florida last night as a Category 4 hurricane, the strongest to ever hit the state’s Big Bend. It is a huge and powerful storm—with a wind field that could span the distance between tjhe State of Maryland/Washington, DC, and Indianapolis/Chicago—that has already caused historic flooding to some of Florida’s coastal communities.
How bad is it? The Waffle House Index, which has been used by FEMA as an indicator of a storm’s severity, closed all of its locations in Tallahassee, Florida. The Waffle House Index [WHI] is an informal metric named after the Waffle House restaurant chain, headquartered in Georgia, and used by the Federal Emergency Management Agency (FEMA) to determine the effect of a storm and the likely scale of assistance required for disaster recovery.
And, as of 8am EST, Helene has weakened to a Category 1 as it’s moved into Atlanta, Georgia. Nearly 2 million customers are without power across Florida, Georgia, and North/South Carolina. You can get real-time updates here, as we hope everyone in the region is staying safe.
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Stock market yesterday: The S&P 500 clinched a fresh new record amid GDP data and micro chip stock gains.and Stonk Stocks. Stonk, a deliberate misspelling of stock (meaning “a share of the value of a company which can be bought, sold, or traded as an investment”), was coined in a 2017 meme. The word is often used humorously on the internet to imply a vague understanding of financial transactions or poor financial decisions.
Upbeat GDP data and new stimulus measures in China were largely to thank. One of the day’s big winners was Southwest Airlines, which soared after executives announced plans to revitalize the business.
COMMENTS APPRECIATED
Thank You
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*** Designated a Doody’s Core Title!
To keep up with the ever-changing field of health care, we must learn new and re-learn old terminology in order to correctly apply it to practice. By bringing together the most up-to-date abbreviations, acronyms, definitions, and terms in the health care industry, the Dictionary offers a wealth of essential information that will help you understand the ever-changing policies and practices in health insurance and managed care today.
Posted on September 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stat: Over 90%. That’s the percentage of the insurance industry’s uptick in fossil fuel securities investment coming from just two firms, State Farm and Berkshire Hathaway. (The Wall Street Journal)
Jabil jumped 11.65% after the electronics parts manufacturer announced impressive earnings and revealed plans to cut costs.
Bilibili, which sounds like you’re trying to get your friend William’s attention, popped 15.44% after Goldman Sachs analysts upgraded the Chinese internet company.
Stocks down
Super Micro Computer plunged 12.17% on the news that the Department of Justice is launching a probe into the tech company, a few weeks after note short seller Hindenburg Research published a report alleging “accounting manipulation.”
Sonos, makers of your favorite subwoofer, sank 4.45% after a rare “double downgrade” by Morgan Stanley analysts, who demoted the stock from a positive “overweight” all the way to a negative “underweight.”
Oil stocks took a big hit today after Saudi Arabia announced it will increase its oil production next month. Diamondback Energy fell 6.46%, Shell dropped 3.91%, and ConocoPhillips lost 3.23%.
The S&P 500® index (SPX) rose 23.11 points (0.40%) to 5,745.37; the Dow Jones Industrial Average® ($DJI) added 260.36 points (0.62%) to 42,175.11; the NASDAQ Composite® ($COMP) increased 108.08 points (0.60%) to 18,190.29.
The 10-year Treasury note yield (TNX) climbed one basis point to 3.79%.
The CBOE Volatility Index® (VIX) was steady at 15.57.
A retreat from ESG is due to backlash from conservatives who are critical of the idea that fund managers should be considering any other factor but a company’s shareholders in their investment decisions. Accusations of “greenwashing” have also plagued many ESG funds, which is when an asset management firm charges higher fees for a specific thematic fund without actually delivering a unique investment strategy.
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Do you ever wish you could acquire specific information for your career activities without having to complete a university Master’s Degree or finish our entire Certified Medical Planner™ professional designation program? Well, Micro-Certifications from the Institute of Medical Business Advisors, Inc., might be the answer. Read on to learn how our three Micro-Certifications offer new opportunities for professional growth in the medical practice, business management, health economics and financial planning, investing and advisory space for physicians, nurses and healthcare professionals.
Micro-Certification Basics
Stock-Brokers, Financial Advisors, Investment Advisors, Accountants, Consultants, Financial Analyists and Financial Planners need to enhance their knowledge skills to better serve the changing and challenging healthcare professional ecosystem. But, it can be difficult to learn and demonstrate mastery of these new skills to employers, clients, physicians or medical prospects. This makes professional advancement difficult. That’s where Micro-Certification and Micro-Credentialing enters the online educational space. It is the process of earning a Micro-Certification, which is like a mini-degree or mini-credential, in a very specific topical area.
Micro-Certification Requirements
Once you’ve completed all of the requirements for our Micro-Certification, you will be awarded proof that you’ve earned it. This might take the form of a paper or digital certificate, which may be a hard document or electronic image, transcript, file, or other official evidence that you’ve completed the necessary work.
Uses of Micro-Certifications
Micro-Certifications may be used to demonstrate to physicians prospective medical clients that you’ve mastered a certain knowledge set. Because of this, Micro-Certifications are useful for those financial service professionals seeking medical clients, employment or career advancement opportunities.
Examples of iMBA, Inc., Micro-Certifications
Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:
1. Health Insurance and Managed Care: To keep up with the ever-changing field of health care physician advice, you must learn new medical practice business models in order to attract and assist physicians and nurse clients. By bringing together the most up-to-date business and medical prctice models [Medicare, Medicaid, PP-ACA, POSs, EPOs, HMOs, PPOs, IPA’s, PPMCs, Accountable Care Organizations, Concierge Medicine, Value Based Care, Physician Pay-for-Performance Initiatives, Hospitalists, Retail and Whole-Sale Medicine, Health Savings Accounts and Medical Unions, etc], this iMBA Inc., Mini-Certification offers a wealth of essential information that will help you understand the ever-changing practices in the next generation of health insurance and managed medical care.
2. Health Economics and Finance: Medical economics, finance, managerial and cost accounting is an integral component of the health care industrial complex. It is broad-based and covers many other industries: insurance, mathematics and statistics, public and population health, provider recruitment and retention, health policy, forecasting, aging and long-term care, and Venture Capital are all commingled arenas. It is essential knowledge that all financial services professionals seeking to serve in the healthcare advisory niche space should possess.
3. Health Information Technology and Security: There is a myth that all physician focused financial advisors understand Health Information Technology [HIT]. In truth, it is often economically misused or financially misunderstood. Moreover, an emerging national HIT architecture often puts the financial advisor or financial planner in a position of maximum uncertainty and minimum productivity regarding issues like: Electronic Medical Records [EMRs] or Electronic Health Records [EHRs], mobile health, tele-health or tele-medicine, Artificial Intelligence [AI], benefits managers and human resource professionals.
Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.
How to Start Learning and Earning Recognition for Your Knowledge
Now that you’re familiar with Micro-Credentialing, you might consider earning a Micro-Certification with us. We offer 3 official Micro-Certificates by completing a one month online course, with a live instructor consisting of twelve asynchronous lessons/online classes [3/wk X 4/weeks = 12 classes]. The earned official completion certificate can be used to demonstrate mastery of a specific skill set and shared with current or future employers, current clients or medical niche financial advisory prospects.
Mini-Certification Tuition, Books and Related Fees
The tuition for each Mini-Certification live online course is $1,250 with the purchase of one required dictionary handbook. Other additional guides, white-papers, videos, files and e-content are all supplied without charge. Alternative courses may be developed in the future subject to demand and may change without notice.
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Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at: MarcinkoAdvisors@msn.com [24/7].
Did you know that at MARCINKO & Associates, all medical colleagues throughout the United States may contact us when they are considering the sale, purchase, strategic operating improvement, merger, acquisition and/or other financial business or related personal financial planning transaction?
Our difference is “hard” knowledge and insider financial guidance that helps medical colleagues, nurses, private practitioners, clinics, ambulatory surgery, radiology and outpatient wound care centers realize their ultimate economic goals. This typically includes managerial and cost accounting, financial ratio analysis, fair market valuation business appraisals, business plan creation and personal financial planning.
Our “expert witness” business litigation support service and divorce mediation, arbitration, asset division, settlement and second opinion offerings are always available, as well.
And, our “soft” skill professional career guidance and mentoring center includes executive coaching, consulting and mentoring advisory programs for stressed, conflicted or burned-out physicians and medical practitioners.
Most importantly, our professional fees are reasonable and always transparent.
MARCINKO & Associates also serves universities, medical, business, graduate and nursing schools; physicians, dentists, podiatrists, optometrists and legal societies. This includes accountants, financial service providers, wealth and hedge fund managers, emerging entities, hospitals, CEOs and their BODs, the press, media and related organizations.
Posted on September 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
Information that Physician Investors Should Know?
By Staff Reporters
DEFINITION: Fractional shares are partial shares of a company’s stock. Instead of owning one or more full shares of the stock, you own a portion, or fraction, of one. In the past, investors generally would end up with fractional shares only after a stock split, since brokers allowed the purchase of full shares only.
A fractional share is a portion of an equity stock that is less than one full share.
Fractional shares often result from stock splits, which don’t always result in an even number of shares.
Mergers or acquisitions create fractional shares, as companies combine new common stock using a predetermined ratio.
Fractional shares can make it easy to buy very small stakes in many different companies. But, if your brokerage charges commissions, you might wind up paying a lot of fees due to the temptation to invest in many different companies.
As a physician executive or investor, if you don’t ordinarily deal in options or other financial derivatives, you may need to brush up on puts and calls, straddles, strangles (or combinations), forwards, futures, swaps, spreads, and non-equity options such as stock index options. Options and other financial derivatives can be used by astute physicians, financial advisors and investment managers not only as a tool to better manage the investment risks potentially affecting portfolio returns, but to craft truly value-added investment strategies customized to meet investors’ needs. The three main types of risk of equity securities (individual company, industry, and market) can be mitigated with options.
Individual Company Risk
Individual company risk can be addressed with equity options in that company’s stock. Industry risk can be reduced through the use of narrow-based index options, while market risk can be mitigated with broad-based index options. Sophisticated hedging and risk management strategies can be designed using both equity and stock index options.
Exotic Stock Options?
Some doctors feel that options have been generally thought of as too risky or exotic or requiring too much capital, resulting in a general lack of comfort. A decade ago, these opinions have no doubt been shaped by the collapse of Bearings and the resulting bitter litigation by Proctor & Gamble and Gibson Greetings against Bankers Trust. Last decade, it was Enron, Tyco, WorldCom, Lehman Brothers, AIG, BA, Fannie, Freddie and all those involved in the “flash-crash” of 2008-09; etc.
Assessment
Generally, premiums paid in buying puts or calls are nondeductible capital expenditures and may produce a capital gain or loss depending upon whether the option is sold prior to exercise, the call expires unexercised, or, if the option is exercised, it is added to the basis of the stock (call) or deducted from it (put). Premiums received for writing puts or calls are not included in income upon receipt but are deferred until the option expires, is exercised, or a closing transaction is entered into. Non-equity options (index options) are marked to market at year end (same as for futures) with 60% considered long-term capital gain and 40% considered short-term.
Note: “An Introduction to Options and Other Financial Derivative Strategies,” by Thomas J. Boczar, Trust & Estates, February 1997, pp. 43–68, INTERTEC/K-III Publishing.
The primary objectives in using derivatives are:
1. Risk management and hedging (reducing or eliminating downside risk, monetizing a position, deferring and possibly avoiding capital gains taxes)
2. Leveraging investment capital
3. Enhancing after-tax returns
4. Creating customized risk/return profiles
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Conclusion
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Long-Short is an active portfolio construction discipline that balances long positions in high expected return securities and short positions in low expected return securities of approximately equal value and market sensitivity. This type of portfolio is “neutralized” or immunized against changes in value of the underlying market and, therefore, has zero systematic (beta) risk. If the selected securities perform as expected, the long-short positions will provide a positive return, whether the market rises or falls.
Misconceptions
While long-short portfolios are often perceived and portrayed as much costlier and much riskier than long-only, it is inherently neither. Much of the incremental cost and risk is either largely dependent on the amount of leverage employed or controllable via optimization. Those costs and risks that are not controllable—financial intermediation costs of borrowing shares to short, the trading costs incurred to meet long-short balancing, margin requirements, uptick rules, and the risks of unlimited losses on short positions—do not invalidate the viability of long-short strategies.
Long-Short Advantages
Compared with long-only portfolios, long-short portfolios offer enhanced flexibility not only in the control of risk and pursuit of return, but also in asset allocation. Basic market-neutral portfolios achieve a return consisting of three components: (1) interest on funds held as a liquidity buffer, (2) interest on the short sale proceeds maintained with the broker, and (3) the return spread between the aggregate long and aggregate short positions in the portfolios.
Disadvantages
Share borrow-ability and uptick rules make short-selling more difficult and costly than going long. Also, it may be legally or contractually restricted for some investors, such as mutual funds. Inefficiencies may be concentrated in overpriced stocks and, accordingly, short sales of the most overpriced stocks may offer higher positive returns than long purchases of underpriced stocks.
Assessment
Long-only portfolios are confined to altering the weighting of securities within an index in order to realize an excess return. Long-short portfolios are not constrained by index weights and, because they can short securities, they can “underweight” a security by as much as investment insights and risk considerations dictate. Long-short portfolios can be enhanced by “equitizing” them using stock index futures.
Note: “The Long and Short on Long-Short” by Bruce I. Jacobs and Kenneth N. Levy, The Journal of Investing, Spring 1997, pp. 73–86, Institutional Investor, Inc.
Conclusion
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Posted on August 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
Delving Deeper into Asset Allocation
By Lon Jefferies MBA CFP® CMP®
Asset allocation is one of the key factors contributing to long-term investment success.
When designing a portfolio that represents their risk tolerance, investors should be aware that a portfolio that is 50% stocks is likely to obtain approximately half of the gain when the market advances but suffer only half the loss when the market declines.
This general principle frequently holds true over extended investing cycles, but can waiver during shorter holding periods.
Case Model
For example, a fairly typical physician client of mine who has a 50% stock, 50% bond portfolio has obtained a return of 4.62% over the last 12 months, while the S&P 500 has obtained a return of 14.31% over the same time period (as of 10/30/14).
An investor expecting to obtain half the return of the index would anticipate a return of 7.15%, and by this measuring stick, has underperformed the market by over 2.50% during the last year.
What caused this differential?
Answer
The issue resides in how we define “the market.” In this example, we use the S&P 500 index as a measure for how the market as a whole is performing. As you may know, the S&P 500 (and the Dow Jones Industrial Average, for that matter) consists solely of large company U.S. stocks.
Of course, a diversified portfolio owns a mixture of large, mid, and small cap U.S. stocks, as well as international and emerging market equities. Consequently, comparing the performance of a basket of only large cap stocks to the performance of a diversified portfolio made up of a variety of different asset classes isn’t an apples-to-apples comparison.
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Frequently, the diversified portfolio will outperform the non-diversified large cap index because several of the components of the diversified portfolio will obtain higher returns than those achieved by large cap holdings.
However, the past 12 months has been a case where a diversified portfolio underperformed the large cap index because large cap stocks were the best performing asset class over the time period. In fact, over the last twelve months, there has been a direct correlation between company size and stock performance (as of 10/30/14):
Large Cap Stocks (S&P 500): 14.92%
Mid Cap Stocks (Russell Mid Cap): 11.08%
Small Cap Stocks (Russell 2000): 4.45%
International Stocks (Dow Jones Developed Markets): -1.05%
Since large cap stocks were the best performing element of a diversified portfolio over the last 12 months, in retrospect, an investor would have obtained a superior return by owning only large cap stocks during the period as opposed to owning a diversified mix of different equities. Does this mean owning only large cap stocks rather than a diversified portfolio is the best investment approach going forward? Of course not.
Year after year, we don’t know which asset category will provide the best return and a diversified portfolio ensures we have exposure to each year’s big winner. Additionally, although large caps were this year’s winner, they could easily be next year’s big loser, and a diversified portfolio ensures we don’t have all our investment eggs in one basket.
Don’t be overly concerned if your diversified portfolio is underperforming a non-diversified benchmark over a short period of time. As always, long-term results should be more heavily weighted than short-term swings, and having a diversified portfolio is likely to maximize the probability of coming out ahead over an extended period.
Conclusion
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The stock markets have been near all time highs, lately. Physician colleagues and clients are so excited that they are even checking the overnight status of favorite stocks and/or the domestic/overseas markets.
Some colleagues are even becoming a bit OCD by checking the implied open of various markets the night before. But, what exactly is the Implied Open? How is it calculated?
DEFINITION: The Implied Open attempts to predict the prices at which various stock indexes will open, at 9:30am New York time. It is frequently shown on various cable television channels prior to the start of the next business day.
EXAMPLE: Considering the DJIA as an example, the basis of calculating implied open is the price of a “DJX index option futures contract”. This is not the price of the DJIA itself but rather the current ticker price of an option issued by the Chicago Board Options Exchange.
CBOE: The Chicago Board Options Exchange, located at 400 South LaSalle Street in Chicago, is the largest U.S. options exchange with annual trading volume that hovered around 1.27 billion contracts at the end of 2014. CBOE offers options on over 2,200 companies, 22 stock indices, and 140 exchange-traded funds.
NOTE: We would like to remind you that new amendments adopted by the U.S. Securities Exchange Commission (SEC) have gone into effect as of September 28, 2021. These amendments restrict the ability of market makers to publish OTC quotations for those companies that have not made required current financial and company information available to regulators and investors.
Although less than 5-10% of the total number of mutual funds are considered true sector funds, year after year, 40-50% or more of the top-performing funds have been sector funds. However, for some physician investors sold on a buy-and-hold strategy, sector funds may not be their cup of tea. But, sector funds do offer an opportunity to outperform the market indices, possibly even substantially, according to Marshall Schield in “Developing a Sector Funds Strategy” (Personal Financial Planning, November/December 1996, pp. 39–42, Warren, Gorham & Lamont, [800] 950-1205).
A Volatile Strategy
Typically sector funds are more volatile than the majority of growth funds. This volatility springs from: (1) the fact that the majority of stocks in a particular sector fund move together, thereby magnifying the fund’s movement; (2) the focus of the sector fund manager only on stocks in that sector, enabling him or her to target high potential stocks; and (3) the rotation of “in” and “out” sectors at particular times.
So – What’s a Doctor Investor to Do?
An investor in sector funds needs a strategy that will target sectors on the upswing and signal when to move out of declining funds. When selecting sector funds, Schield recommends building a list of funds that are manageable, full of choices in all types of markets, diversified (three to four funds for an aggressive portfolio or 10–12 for a less aggressive approach) and liquid.
The Balancing Act
Also, develop a healthy balance—not a “hit-or-miss” approach. Schield suggested using the “relative strength” approach for sector selection by computing the percent change in the price of funds over a certain number of days and then ranking them for short-term, intermediate, and long-term periods. With respect to determining the proper timing for buying or selling, the author suggests the use of an individual fund timing system, such as comparing the current NAV of the sector against a moving average for 50 or 75 days or combining both short- and long-term moving averages.
Simplicity Rules
In creating buy-and-sell signals:
Keep it simple and manageable.
Do not look for perfection.
Practice patience.
Cut losses and let profits run.
Stick with your relative strength.
Buy/sell signals consistently.
Assessment
Most of all; be prepared to spend and invest the time necessary to be successful. But, have you or your sector funds been successful in the last decade, or so? If so, which sectors? Please opine?’
Conclusion
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Statistics: 7.4%. That’s the percentage drop in students who graduated with a degree in accounting in the 2021–2022 school year than the year before. Low starting salaries, heavy workloads, and uncertainty around AI are driving the exodus of students from choosing accounting degrees. (the Wall Street Journal).
Physician and all investors are often overloaded with information regarding this debate, and many advisors differ in the conclusion of which strategy is best.
Stock Picking
Stock picking is typically a waist of time and few investors or advisors demonstrate the constant ability in picking winning stocks. Timing the market also becomes difficult and typically has negative effects in a portfolio. Investors will also find that they will usually have very little luck finding money mangers that can consistently out perform the market. Investors over a long period of investing time horizon would benefit from passive investing vs. active trading, with some exceptions.
Active Investors
Active investors spend time analyzing stocks or mutual funds based on a mismatch of the price relative to its value. In an efficient market, there is little or no mismatch between the current price and the true value of the investment. Also, real cost and expenses of active management are rarely calculated; some consider the stock market a zero sum game, if the total market returns eleven percent then the investors must deduct the cost of the transaction, which would lower their return relative to the market.
Mutual Fund Performance
For example, Mark Carhart’s comprehensive study of 1,892 mutual funds title “On Persistence in Mutual Fund Performance” showed that on average mutual fund manager under performs by 1.8% to their relative index. In addition, William Sharpe Nobel laureate article “The Arithmetic of Active Management” stated that after cost, the return of active management dollars would be less than passive dollars.
Market Timing
Timing of markets is also very difficult. Timing the market can be defined by moving your asset from risky to non risky assets before negative events happen. The Random Walk Theory basically states that there are no patterns in the stock market prices. Basically, information moves the markets and information is random, so logic would suggest that timing the markets effectively is futile. Many reports demonstrate this effect, for example, a report form Javier Estrada, a finance professor at IESE Business School in Barcelona, Spain. He studied the DJIA form 1900-2008 and concluded that if you subtracted the ten best days from the market two thirds of the cumulative gains would disappear (10/29694 or .03%), almost impossible to predict even by the most astute investors. Much more extensive research showing that market timing does not work, Wei Jiang paper “A Nonparametric Test of Market Timing” concluded that timing ability on average is negative. There are countless of studies showing that there is no evidence that timing the markets can produce superior returns.
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Investing Difficulties Continue
To make thing even more difficult, investors that seek profession help cannot guarantee that the active managers they hire can consistently over long period of time outperform their benchmarks. Obviously, it is evident that past performance is no indication of future results as advertised by all financial institution, and most active managers who outperform their bench market do not do consistently over long periods of time. John Boggle’s comprehensive study in 1992 of the Forbes Honor Roll title “Selecting Equity Mutual Funds” concluded that after commissions loads were taken into account the honor roll under performed the market between 1974 and 1990 by a difference of 193.75% cumulative.
Of Professor Burton Malkiel
Furthermore, investors over long periods of time will find that stock picking, timing the market and selecting active managers do not produce superior returns. John Stossel of ABC’s 20/20 interview Professor Burton Malkiel of Princeton University and stated in the interview that “All the information an analyst can learn about a company, from balance sheets to marketing material, is already built into the stock price, because all of the other thousands of analysts have the same information. What they don’t have is the knowledge that will move the stock, knowledge such as a news event, which is unpredictable and impossible to forecast.”
Assessment
Physicians and all investors may be better off concentrating on asset allocation, picking low cost investment, deciding on tactical or strategic rebalancing and implementing models like the three factor model as pioneered by Professor Eugene Fama and Professor Kenneth French in lieu active management.
Conclusion
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A retirement nest egg of $2.5 million can likely produce an annual income of $100,000 for as long as you are likely to live. This is using the 4% withdrawal rate many financial advisors consider standard. After starting with the first withdrawal of 4% of the total, the annual withdrawal will adjust for inflation. For example, if inflation runs at the target 2% rate of federal policymakers, during retirement the retiree will withdraw:
$100,000
in the first year
$102,000
in the second year
$104,040
in the third year and so on …
According to this model and conventional wisdom, a 4% withdrawal rate will allow a portfolio to last for at least 30 years. This would permit a 65-year-old retiree to maintain consistent purchasing power until age 95 and beyond.
For most retirees, this will likely be adequate to maintain a satisfying standard of living. Only about 3% of 2,000 retirees surveyed by the Employee Benefit Research Institute in 2022 spent $7,000 or more per month, equivalent to $84,000 in annual spending.
This model does not include a number of other factors. For instance, nearly all retirees are eligible for Social Security. For 2023, the maximum monthly Social Security benefit for people who claim benefits at full retirement age is $3,627. That’s equal to more than half the spending of the top 3% of retirees surveyed by EBRI. And, like the standard withdrawal rate, Social Security benefits are indexed to inflation.
5 Variables for Retiring With $2.5 Million at Age 65
While $2.5 million could seem like enough to retire at 65, many factors could change the outlook.
1. Unexpected Healthcare Costs
The Fidelity Retiree Health Care Cost Estimate suggests an average 65-year-old couple could need (approximate, after taxes):
This assumes both spouses are enrolled in traditional Medicare, which between Medicare Part A and Part B covers expenses such as hospital stays, doctor visits and services, physical therapy, lab tests and more, and in Medicare Part D, which covers prescription drugs.
This figure does not include long-term care (“custodial care”), most dental care, eye exams and more, so your estimated healthcare costs in retirement could be considerably more.
2. Inflation
Inflation can powerfully influence retirees’ financial well-being. When inflation occurs, it reduces the purchasing power of money withdrawn from your retirement account. You can increase withdrawals to maintain purchasing power, but this risks more quickly depleting your savings.
3. Market Downturns
Inflation isn’t the only cause of market downturns. Business cycles and financial crises can exaggerate normal fluctuations in stock market valuations. If you’re selling investments to generate income for living expenses, you may want to sell more if valuations are down.
4. Longevity
While living a long life is positive, you could outlive the money you’ve saved for retirement. Many financial planners use life expectancy to age 95 or 100 when developing plans for funding retirement.
The Social Security Administration says an average 65-year-old male can live to age 83, while the average woman can live to age 86. However, people in their 80s and 90s also generally reduce their spending, with the exception of healthcare costs.
5. Estate Planning
Retiring at 65 with $2.5 million likely involved generating high income and savings, so there’s a chance you could have assets to pass on. With estate planning, adding members of your family as beneficiaries for homes you paid off with a mortgage may have long-term positives.
You may also want to think about any additional income streams. For example, if you own a medical practice or business, you may want to add your family as a beneficiary so they can decide to keep the business running or sell it.
Posted on June 2, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
Understanding the Difference
By Rick Kahler CFP®
Retirement planning is one of the issues that commonly lead clients to consult financial advisers.
One of its essential aspects is creating a plan to save and invest in order to provide a comfortable retirement income. Ideally, this starts many years ahead of retirement, even as early as your first paycheck.
As retirement comes closer, planning for it expands to take in a host of other considerations, such as deciding when to retire, where to live, and what kind of lifestyle you hope to have. When retirement becomes a reality, the focus shifts to carrying out the plan.
Preparing
All of this planning is crucial. Yet, for both financial advisers and clients, it’s good to keep in mind that planning has its limits. In the post-retirement years, it may be helpful to think in terms of preparing for old age rather than planning for it.
The older we get, the more important this distinction between planning and preparing becomes. Too many life-changing things can happen without regard to our best-laid plans. Often they occur unexpectedly, resulting in emergency situations where urgent decisions have to be made. A stroke or a fall, a diagnosis of terminal illness, a broken hip that leaves someone unable to go back to independent living—and suddenly, right now, the family needs to find an assisted living facility, arrange for live-in help, or sell a home.
What are some of the ways to prepare for these contingencies?
Explore housing options well ahead of time. Find out what assisted living, home care, and nursing home services and facilities are available where you live and whether they have waiting lists. Have family conversations about possibilities like relocating or sharing households:
Research the financial side of these options. Investigate the cost of hiring help at home, assisted living facilities, and nursing care centers. Find out what is and is not covered by Medicare and long-term care insurance. For example, people are sometimes surprised to learn that Medicare does not pay for nursing home care other than short-term medical stays.
Designate someone to take over decision-making, and do the paperwork. Execute documents like a living will, medical power of attorney, and contingent power of attorney. Update them as necessary, and give copies to your doctors, your financial planner, and appropriate family members.
Start relatively early to downsize. Well before you’re ready to let go of possessions or move into smaller housing, start considering what to do with your “stuff.” Focus on the decisions rather than the distribution. There’s no need to get rid of possessions prematurely, but decide what you want to do with them—and put in writing. Do this while it’s still your choice, rather than something your family members do while you’re in the hospital or nursing home
Do your best to practice flexibility and acceptance. No matter how strongly you want to live in your own home until the end of your life, for example, it may not be possible. The physical limitations of aging can limit our choices, and even the best options available may not be what we would like them to be. It is a profound gift to yourself and your family members to accept these realities with as much grace as you can muster.
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Assessment
Finally, please don’t underestimate the importance of planning financially for retirement. Because the bottom line is that you can’t plan for all the things that might happen as you age, but you can prepare to deal with them. One of the most useful tools to cope with those contingencies is having enough money.
Conclusion
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Posted on June 1, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
A Vital Feedback Loop for any Medical Professional’s Investment Program
By Dr. David Edward Marcinko MBA, MEd, CMP™
[Publisher-in-Chief]
While recently visiting the beautiful Johns Hopkins University and Medical School in Baltimore Maryland, I realized that investment portfolio performance measurement — much like an annual physical exam in the Spring — is an important feedback loop to monitor progress towards the goals of the medical professional’s investment program.
Performance comparisons to market indices and/or peer groups are a useful part of this feedback loop, as long as they are considered in the context of the market environment and with the limitations of market index and manager database construction. Inherent to performance comparisons is the reality that portfolios taking greater risk will tend to out-perform less risky investments during bullish phases of a market cycle, but are also more likely to under-perform during the bearish phase. The reason for focusing on performance comparisons over a full market cycle is that the phases biasing results in favor of higher risk approaches can be balanced with less favorable environments for aggressive approaches to lessen/eliminate those biases.
THINK: The “flash crash” of March 2009, and the DJIA now hovering near a record of late.
The Biases
Can we eliminate the biases of the market environment by adjusting performance for the risk assumed by the portfolio? While several interesting calculations have been developed to measure risk-adjusted performance, the unfortunate answer is that the biases of the market environment still tend to have an impact even after adjusting returns for various measures of risk.
Assessment
However, medical professionals and their advisors will have many different risk-adjusted return statistics presented to them, so understanding the Sharpe ratio, Treynor ratio, Jensen’s measure or alpha, Morningstar star ratings, etc. and their limitations should help to improve the decisions made from the performance measurement feedback loop.
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There are two distinct forms of financial analysis investment strategies often used by medical colleague investors who desire to pursue an active investment strategy.
Technical Analysis: Technical analysts, sometimes referred to as chartists, use historical price data and transaction volume data to identify mis-priced securities. A key belief shared by technical analysts is that stock prices follow recurring patterns and that once these historical patterns are identified, they can be used to identify future security prices. The heart of technical analysis is identifying significant shifts in the macro/micro economic supply and demand factors for a particular securities investment.
Skeptics of technical analysis generally subscribe to the notion that the markets efficiently and accurately price securities. In fact, the weak form of the Efficient Market Hypothesis [EMH] is based on the view that investors cannot consistently earn superior returns using historical data and technical analysis alone.
Fundamental Analysis: In contrast to technical analysis – which relies on historical market returns / transactions data – fundamental analysis focuses on the underlying company’s assets, earnings, risks, dividends and intrinsic security factors to identify mis-priced securities.
Furthermore, investors using fundamental analysis can use either a top-down or bottom-up approach:
The top-down investor starts with global economics, including both international and national economic indicators. These may include GDP growth rates, inflation, interest rates, exchange rates, productivity and energy prices. They subsequently narrow their search to regional / industry analysis of total sales, price levels, the effects of competing products, foreign competition and entry or exit from the industry. Often they refine their search to the best business in the area being studied.
The bottom-up investor starts with specific businesses, regardless of their industry / region, and proceeds in reverse of the top-down approach. Bottom-up investing is an approach that focuses on analyzing individual stocks and de-emphasizes the significance of macroeconomic and market cycles. In other words, bottom-up investing typically involves focusing on a specific company’s fundamentals, such as revenue or earnings, versus the industry or the overall economy. The bottom-up investing approach assumes individual companies can perform well even in an industry that is under performing, at least on a relative basis.
And so, a medical professional utilizing fundamental analysis is attempting to find securities that are trading at market prices below their intrinsic value. Skeptics suggest this is difficult or almost impossible to achieve.
Thus, while technical analysis focuses on market price history, a security’s intrinsic fundamental analysis is determined independent of the security’s market value. Of course, a combination of both fundamental and technical analysis can also be considered.
Check back periodically for practical updates. Our catalogue library of major books, texts, case models and dictionaries is suggested for additional financial, economic, business and medical practice management information and education.
One relatively recent performance evaluation approach that was developed to help improve the relevance of comparisons is the separation of stock universes and managers by style. This classification method attempts to distinguish between stocks or manager philosophies based upon general financial characteristics of the investments.
The Managers
In very general terms, a manager is often a growth manager if the investment approach that the manager uses focuses on stocks showing growth and momentum in its earnings and price.
A value manager is generally considered to be a manager that attempts to identify under-valued securities based upon fundamental analysis of the company. A stock may be considered either “growth” or “value” based on a given set of valuation measures such as price-to-earnings, price-to-book value, and dividend yield.
The Style
The goal of style-based performance comparisons is to take some of the biases of the market environment out of the comparison, since a portfolio’s returns will ideally be evaluated versus a universe of alternatives that represent similar investment characteristics facing the same basic market environment. Thus, if the environment is one in which investors in stocks with strong past earnings and price momentum have generally performed better than those using fundamental analysis to find under-valued stocks, comparing the growth/momentum portfolio to a growth index or universe should help eliminate the bias.
Style-based universes can help the medical professional better understand the basic environment captured over a given performance time period.
However, there are significant limitations with the various approaches to constructing style-based stock and manager universes that should be understood if they are to be used in direct performance comparisons. Taking style-based stock universes separately from style-based manager universe, one of the most significant issues regarding the categorization of stocks by “growth” and “value” styles is the lack of agreement in the specification of what a growth stock is versus a value stock. With some universes divided by price-to-book value, others by price-to-earnings and/or dividend yields and some by combinations of similar variables, stocks are often classified very differently by two different stock universes. Further, stocks move across a broad spectrum as their price and fundamentals change, resulting in stocks constantly moving between growth and value categories for any given universe. If there is ambiguity in the rating of a given stock, then the difficulty is only compounded when we attempt to boil what may be complex investment processes of an investment manager or mutual fund portfolio manager to a simple classification of growth or value. A beaten down cyclical stock that no self-respecting growth/momentum manager would purchase may be classified as “growth” because it has a high price-to-earnings ratio (i.e., from low earnings) or a high price-to-book value (i.e., from asset write-offs). Value managers are not the only ones to own low valuation stocks that have improving earnings.
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The second problem with style categorization is that managers are often misclassified or they purposefully “game” the categorization of their own process in order to appear more competitive. As an example, if a manager that typically looks for relatively strong earnings/price momentum is lagging in a period when “growth” managers are outperforming, the rank of the manager can be improved simply by claiming a “value” approach. Morningstar’s “style box” classification of mutual funds by size and style of the current portfolio highlight this problem for any given fund by showing how their portfolio has changed its classification annually.
Current Events
The stock market has been booming lately. Up almost 100% since March 2009, after being down almost 50%. And so, perhaps this is a good time to re-evaluate the performance of your investment portfolio[s].
Assessment
However, this leads to an interesting question for the medical professional or his/her advisor: If a manager is still using the same basic investment philosophy and disciplines, but their “style” category has changed according to the ratings service, should you fire them? If the answer is “yes”, then the burden of monitoring and the cost of manager turnover are an inevitable part of narrow style based performance comparisons.
But, if the answer is “no,” then it is easy to see the difficulty of fitting every management approach into a simple style box. The more reasonable alternative is to use style-based stock and manager universes as a tool for understanding the environment, rather than an absolute performance benchmark.
Conclusion
And so, 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.
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Modern Portfolio Theory approaches investing by examining the complete market and the full economy. MPT places a great emphasis on the correlation between investments.
DEFINITION:
Correlation is a measure of how frequently one event tends to happen when another event happens. High positive correlation means two events usually happen together – high SAT scores and getting through college for instance. High negative correlation means two events tend not to happen together – high SATs and a poor grade record.
No correlation means the two events are independent of one another. In statistical terms two events that are perfectly correlated have a “correlation coefficient” of 1; two events that are perfectly negatively correlated have a correlation coefficient of -1; and two events that have zero correlation have a coefficient of 0.
Correlation has been used over the past twenty years by institutions and financial advisors to assemble portfolios of moderate risk. In calculating correlation, a statistician would examine the possibility of two events happening together, namely:
If the probability of A happening is 1/X;
And the probability of B happening is 1/Y; then
The probability of A and B happening together is (1/X) times (1/Y), or 1/(X times Y).
There are several laws of correlation including;
Combining assets with a perfect positive correlation offers no reduction in portfolio risk. These two assets will simply move in tandem with each other.
Combining assets with zero correlation (statistically independent) reduces the risk of the portfolio. If more assets with uncorrelated returns are added to the portfolio, significant risk reduction can be achieved.
Combing assets with a perfect negative correlation could eliminate risk entirely. This is the principle with “hedging strategies”. These strategies are discussed later in the book.
In the real world, negative correlations are very rare
Most assets maintain a positive correlation with each other. The goal of a prudent investor is to assemble a portfolio that contains uncorrelated assets. When a portfolio contains assets that possess low correlations, the upward movement of one asset class will help offset the downward movement of another. This is especially important when economic and market conditions change.
As a result, including assets in your portfolio that are not highly correlated will reduce the overall volatility (as measured by standard deviation) and may also increase long-term investment returns. This is the primary argument for including dissimilar asset classes in your portfolio. Keep in mind that this type of diversification does not guarantee you will avoid a loss. It simply minimizes the chance of loss.
In the table provided by Ibbotson, the average correlation between the five major asset classes is displayed. The lowest correlation is between the U.S. Treasury Bonds and the EAFE (international stocks). The highest correlation is between the S&P 500 and the EAFE; 0.77 or 77 percent. This signifies a prominent level of correlation that has grown even larger during this decade. Low correlations within the table appear most with U.S. Treasury Bills.
Posted on April 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson, CFA ***
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Something weird happened to me on Twitter a few months ago. A “follower” started lashing out at me about a stock we own. When people attack me for my views it doesn’t bother me (I wrote several chapters in Soul in the Game on this topic). I don’t let personal attacks get to me, unless people start attaching bricks to their 280 characters.
This person’s lambasting of me was different. He was upset about the decline of a stock I had never publicly discussed in any of my newsletters or talks. This person was not a client. I didn’t know who he was; I had never met him. I was really confused why a stock my clients and I personally owned was so important to him. It’s like someone being upset about the color my wife chose to paint our kitchen.
Once gently confronted, he apologized, said he was a big fan, and explained that he had read my 13F (a form we have to file with the SEC 45 days after the quarter end, where we have to report our holdings in US stocks). He saw that the stock was one of our top holdings, and he bought it. Because I owned it, he made it a disproportionately large position.
I was truly upset about this incident. One of my principles in life is to have a net positive impact on the people I touch. If every single stock I discussed only went straight up, I wouldn’t have to worry about it. But this is not how life works.
Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it. The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so! It is the type of definitive financial lifestyle planning book we often seek, but seldom find. —LeRoy Howard MA CMPTM,Candidate and Financial Advisor, Fayetteville, North Carolina I taught diagnostic radiology for over a decade. The physician-focused niche information, balanced perspectives, and insider industry transparency in this book may help save your financial life. —Dr. William P. Scherer MS, Barry University, Ft. Lauderdale, Florida This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs. It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional. —Parin Khotari MBA,Whitman School of Management, Syracuse University, New York In today’s healthcare environment, in order for providers to survive, they need to understand their current and future market trends, finances, operations, and impact of federal and state regulations. As a healthcare consulting professional for over 30 years supporting both the private and public sector, I recommend that providers understand and utilize the wealth of knowledge that is being conveyed in these chapters. Without this guidance providers will have a hard time navigating the supporting system which may impact their future revenue stream. I strongly endorse the contents of this book.—Carol S. Miller BSN MBA PMP,President, Miller Consulting Group, ACT IAC Executive Committee Vice-Chair at-Large, HIMSS NCA Board Member This is an excellent book on financial planning for physicians and health professionals. It is all inclusive yet very easy to read with much valuable information. And, I have been expanding my business knowledge with all of Dr. Marcinko’s prior books. I highly recommend this one, too. It is a fine educational tool for all doctors.—Dr. David B. Lumsden MD MS MA,Orthopedic Surgeon, Baltimore, Maryland There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them. —Dr. Jason Dyken MD MBA,Dyken Wealth Strategies, Gulf Shores, Alabama I plan to give a copy of this book written ‘by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic. —Alexander Naruska CPA,Orlando, Florida
Health professionals are small business owners who need to apply their self-discipline tactics in establishing and operating successful practices. Talented trainees are leaving the medical profession because they fail to balance the cost of attendance against a realistic business and financial plan. Principles like budgeting, saving, and living below one’s means, in order to make future investments for future growth, asset protection, and retirement possible are often lacking. This textbook guides the medical professional in his/her financial planning life journey from start to finish. It ranks a place in all medical school libraries and on each of our bookshelves. —Dr. Thomas M. DeLauro DPM,Professor and Chairman – Division of Medical Sciences, New York College of Podiatric Medicine
Physicians are notoriously excellent at diagnosing and treating medical conditions. However, they are also notoriously deficient in managing the business aspects of their medical practices. Most will earn $20-30 million in their medical lifetime, but few know how to create wealth for themselves and their families. This book will help fill the void in physicians’ financial education. I have two recommendations: 1) every physician, young and old, should read this book; and 2) read it a second time! —Dr. Neil Baum MD,Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, Louisiana
I worked with a Certified Medical Planner™ on several occasions in the past, and will do so again in the future. This book codified the vast body of knowledge that helped in all facets of my financial life and professional medical practice. —Dr. James E. Williams DABPS, Foot and Ankle Surgeon, Conyers, Georgia
This is a constantly changing field for rules, regulations, taxes, insurance, compliance, and investments. This book assists readers, and their financial advisors, in keeping up with what’s going on in the healthcare field that all doctors need to know. —Patricia Raskob CFP® EA ATA, Raskob Kambourian Financial Advisors, Tucson, Arizona I particularly enjoyed reading the specific examples in this book which pointed out the perils of risk … something with which I am too familiar and have learned (the hard way) to avoid like the Black Death. It is a pleasure to come across this kind of wisdom, in print, that other colleagues may learn before it’s too late— many, many years down the road. —Dr. Robert S. Park MD, Robert Park and Associates Insurance, Seattle, Washington
Although this book targets physicians, I was pleased to see that it also addressed the financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable. —Nurse Cecelia T. Perez RN, Hospital Operating Room Manager, Ellicott City, Maryland
Personal financial success in the PP-ACA era will be more difficult to achieve than ever before. It requires the next generation of doctors to rethink frugality, delay gratification, and redefine the very definition of success and work–life balance. And, they will surely need the subject matter medical specificity and new-wave professional guidance offered in this book. This book is a ‘must-read’ for all health care professionals, and their financial advisors, who wish to take an active role in creating a new subset of informed and pioneering professionals known as Certified Medical Planners™. —Dr. Mark D. Dollard FACFAS, Private Practice, Tyson Corner, Virginia As healthcare professionals, it is our Hippocratic duty to avoid preventable harm by paying attention. On the other hand, some of us are guilty of being reckless with our own financial health—delaying serious consideration of investments, taxation, retirement income, estate planning, and inheritances until the worry keeps one awake at night. So, if you have avoided planning for the future for far too long, perhaps it is time to take that first step toward preparedness. This in-depth textbook is an excellent starting point—not only because of its readability, but because of his team’s expertise and thoroughness in addressing the intricacies of modern investments—and from the point of view of not only gifted financial experts, but as healthcare providers, as well … a rare combination. —Dr. Darrell K. Pruitt DDS, Private Practice Dentist, Fort Worth, Texas This text should be on the bookshelf of all contemporary physicians. The book is physician-focused with unique topics applicable to all medical professionals. But, it also offers helpful insights into the new tax and estate laws, fiduciary accountability for advisors and insurance agents, with investing, asset protection and risk management, and retirement planning strategies with updates for the brave new world of global payments of the Patient Protection and Affordable Care Act. Starting out by encouraging readers to examine their personal ‘money blueprint’ beliefs and habits, the book is divided into four sections offering holistic life cycle financial information and economic education directed to new, mid-career, and mature physicians.
This structure permits one to dip into the book based on personal need to find relief, rather than to overwhelm. Given the complexity of modern domestic healthcare, and the daunting challenges faced by physicians who try to stay abreast of clinical medicine and the ever-evolving laws of personal finance, this textbook could not have come at a better time. —Dr. Philippa Kennealy MD MPH, The Entrepreneurial MD, Los Angeles, California Physicians have economic concerns unmatched by any other profession, arriving ten years late to the start of their earning years. This textbook goes to the core of how to level the playing field quickly, and efficaciously, by a new breed of dedicated Certified Medical Planners™. With physician-focused financial advice, each chapter is a building block to your financial fortress. —Thomas McKeon, MBA, Pharmaceutical Representative, Philadelphia, Pennsylvania An excellent resource … this textbook is written in a manner that provides physician practice owners with a comprehensive guide to financial planning and related topics for their professional practice in a way that is easily comprehended. The style in which it breaks down the intricacies of the current physician practice landscape makes it a ‘must-read’ for those physicians (and their advisors) practicing in the volatile era of healthcare reform. —Robert James Cimasi, MHA ASA FRICS MCBA CVA CM&AA CMP™, CEO-Health Capital Consultants, LLC, St. Louis, Missouri Rarely can one find a full compendium of information within a single source or text, but this book communicates the new financial realities we are forced to confront; it is full of opportunities for minimizing tax liability and maximizing income potential. We’re recommending it to all our medical practice management clients across the entire healthcare spectrum. —Alan Guinn, The Guinn Consultancy Group, Inc., Cookeville, Tennessee Dr. David Edward Marcinko MBA CMP™ and his team take a seemingly endless stream of disparate concepts and integrate them into a simple, straightforward, and understandable path to success. And, he codifies them all into a step-by-step algorithm to more efficient investing, risk management, taxation, and enhanced retirement planning for doctors and nurses. His text is a vital read—and must execute—book for all healthcare professionals and physician-focused financial advisors. —Dr. O. Kent Mercado, JD, Private Practitioner and Attorney, Naperville, Illinois
Kudos. The editors and contributing authors have compiled the most comprehensive reference book for the medical community that has ever been attempted. As you review the chapters of interest and hone in on the most important concerns you may have, realize that the best minds have been harvested for you to plan well… Live well. —Martha J. Schilling; AAMS® CRPC® ETSC CSA, Shilling Group Advisors, LLC, Philadelphia, Pennsylvania I recommend this book to any physician or medical professional that desires an honest no-sales approach to understanding the financial planning and investing world. It is worthwhile to any financial advisor interested in this space, as well. —David K. Luke, MIM MS-PFP CMP™, Net Worth Advisory Group, Sandy, Utah Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisor. I highly recommend it and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done. —Ken Yeung MBA CMP™, Tseung Kwan O Hospital, Hong Kong I’ve seen many ghost-written handbooks, paperbacks, and vanity-published manuals on this topic throughout my career in mental healthcare. Most were poorly written, opinionated, and cheaply produced self-aggrandizing marketing drivel for those agents selling commission-based financial products and expensive advisory services. So, I was pleasantly surprised with this comprehensive peer-reviewed academic textbook, complete with citations, case examples, and real-life integrated strategies by and for medical professionals. Although a bit late for my career, I recommend it highly to all my younger colleagues … It’s credibility and specificity stand alone. —Dr. Clarice Montgomery PhD MA,Retired Clinical Psychologist In an industry known for one-size-fits-all templates and massively customized books, products, advice, and services, the extreme healthcare specificity of this text is both refreshing and comprehensive. —Dr. James Joseph Bartley, Columbus, Georgia
My brother was my office administrator and accountant. We both feel this is the most comprehensive textbook available on financial planning for healthcare providers. —Dr. Anthony Robert Naruska DC,Winter Park, Florida
Posted on March 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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You don’t have to worry about the market and its crazy valuations. That’s your neighbor’s problem, not yours. In building your portfolio, we are aiming for resilience.
About twelve years ago the South Dakota Investment Council combined two of their asset classes, domestic and international stocks, into one, global stocks. While this move didn’t make the nightly news, it did signify a growing trend.
Many investment managers no longer view the US stock market as a separate asset class from the rest of the world’s stock markets.
Today they view it as one component of a global asset class of stocks.
Diversify
For the same reason you don’t want to own just one company’s stock in your portfolio, it makes no sense for an individual investing for retirement to own just US stocks. It’s as important to diversify among countries as among companies.
The question then becomes how much of a global stock portfolio should be in US stocks and how much in international stocks. For many years the standard thinking of portfolio managers was still to over-allocate to the US. It was, and to some degree still is, common to see 80% of a portfolio’s equity allocation in US stocks.
That over-allocation has never made a lot of sense to me, considering that the US accounts for far less than 80% of the global market capitalization. In the 1980’s, US companies accounted for about 65% of the global capitalization. Accordingly, I weighted my stock portfolios with 65% US and 35% international. By 1999, the US had slipped to 50%. I adjusted my portfolios accordingly.
The latest statistics from Dimensional Fund Advisors show the US still accounts for around 50% of the global capitalization. Investors who want to maintain a true global diversification of their stock portfolios will need to seriously consider reducing their US allocation.
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Which, Where and How to Invest
Which international stocks, then, should you add? Developed regions and countries like those of Europe, Australia Pacific, and Japan account for about 40% of the total global capitalization. Emerging market countries, many in Southwest Asia and Latin America, make up the remaining 10%. Weighting your portfolio accordingly gives you a well-diversified stock portfolio that has a high probability of withstanding the inevitable rise and fall of equity markets.
How do you invest globally? There are mutual funds that invest in specific countries, in regions, internationally, or globally. I don’t really like the country funds, as I don’t know which countries I should be underweighting or overweighting. Besides, creating a global index using country funds can be a lot of work and expense.
Using index regional funds is an easier way to invest in international stocks. To allocate according to the global capitalization percentages above, you would include three index mutual funds in your stock portfolio: one broad market US fund, an international fund of developed (non-emerging markets), and an emerging markets fund.
If you want even more simplicity, invest in one good global fund. The difference between an “international” fund and a “global” or “world” fund is that a global fund will include US stocks where an international fund won’t. Vanguard Total World Stock ETF comes to mind as one of the better “one size fits all” global funds that will invest in a mixture of countries, including the US. This one fund holds 7,164 stocks in 47 countries. You really need nothing more in the equity portion of your portfolio.
Assessment
While it isn’t necessary to allocate your stocks strictly according to global capitalization percentages, research suggest you will probably do better in the long run to do so. Whether you decide to own country, regional, international, or global funds, what’s most important is that you diversify your stock portfolio globally. In today’s world, it’s an important component of diversified investing.
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:
Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it. The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so! It is the type of definitive financial lifestyle planning book we often seek, but seldom find.
LeRoy Howard MA CMPTM [Candidate and Financial Advisor, Fayetteville, North Carolina]
The giant accounting firm Grant Thornton LLP is laying off 200 people, its second round of layoffs in the past six months and an indication that the major players in the professional consulting, accounting and advisory business are preparing for an economic slowdown that could squeeze profits across corporate America.
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Statistics: 7.4%. That’s the percentage drop in students who graduated with a degree in accounting in the 2021–2022 school year than the year before. Low starting salaries, heavy workloads, and uncertainty around AI are driving the exodus of students from choosing accounting degrees. (the Wall Street Journal).
Posted on February 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A stock buyback is when a public company uses cash to buy shares of its own stock on the open market. A company may do this to return money to shareholders that it doesn’t need to fund operations and other investments
Share buybacks can create value for investors in a few ways: Repurchases return cash to shareholders who want to exit the investment. With a buyback, the company can increase earnings per share, all else equal. The same earnings pie cut into fewer slices is worth a greater share of the earnings.
A stock buyback typically means that the price of the remaining outstanding shares increases. This is simple supply-and-demand economics: there are fewer outstanding shares, but the value of the company has not changed, therefore each share is worth more, so the price goes up.
But, the practice has faced criticism from labor unions, the SEC, and even President Biden, who proposed stricter stock buyback regulations for company execs last week.
Nevertheless,
Stock buybacks from S&P 500 companies are expected to pass $1 trillion this year, after hitting a record $882 billion in 2021, according to Goldman Sachs.
In recent years, Starbucks spent $13.5 billion repurchasing shares.
Do you ever wish you could acquire specific information for your career activities without having to complete a university Master’s Degree or finish our entire Certified Medical Planner™ professional designation program? Well, Micro-Certifications from the Institute of Medical Business Advisors, Inc., might be the answer. Read on to learn how our three Micro-Certifications offer new opportunities for professional growth in the medical practice, business management, health economics and financial planning, investing and advisory space for physicians, nurses and healthcare professionals.
Micro-Certification Basics
Stock-Brokers, Financial Advisors, Investment Advisors, Accountants, Consultants, Financial Analyists and Financial Planners need to enhance their knowledge skills to better serve the changing and challenging healthcare professional ecosystem. But, it can be difficult to learn and demonstrate mastery of these new skills to employers, clients, physicians or medical prospects. This makes professional advancement difficult. That’s where Micro-Certification and Micro-Credentialing enters the online educational space. It is the process of earning a Micro-Certification, which is like a mini-degree or mini-credential, in a very specific topical area.
Micro-Certification Requirements
Once you’ve completed all of the requirements for our Micro-Certification, you will be awarded proof that you’ve earned it. This might take the form of a paper or digital certificate, which may be a hard document or electronic image, transcript, file, or other official evidence that you’ve completed the necessary work.
Uses of Micro-Certifications
Micro-Certifications may be used to demonstrate to physicians prospective medical clients that you’ve mastered a certain knowledge set. Because of this, Micro-Certifications are useful for those financial service professionals seeking medical clients, employment or career advancement opportunities.
Examples of iMBA, Inc., Micro-Certifications
Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:
1. Health Insurance and Managed Care: To keep up with the ever-changing field of health care physician advice, you must learn new medical practice business models in order to attract and assist physicians and nurse clients. By bringing together the most up-to-date business and medical prctice models [Medicare, Medicaid, PP-ACA, POSs, EPOs, HMOs, PPOs, IPA’s, PPMCs, Accountable Care Organizations, Concierge Medicine, Value Based Care, Physician Pay-for-Performance Initiatives, Hospitalists, Retail and Whole-Sale Medicine, Health Savings Accounts and Medical Unions, etc], this iMBA Inc., Mini-Certification offers a wealth of essential information that will help you understand the ever-changing practices in the next generation of health insurance and managed medical care.
2. Health Economics and Finance: Medical economics, finance, managerial and cost accounting is an integral component of the health care industrial complex. It is broad-based and covers many other industries: insurance, mathematics and statistics, public and population health, provider recruitment and retention, health policy, forecasting, aging and long-term care, and Venture Capital are all commingled arenas. It is essential knowledge that all financial services professionals seeking to serve in the healthcare advisory niche space should possess.
3. Health Information Technology and Security: There is a myth that all physician focused financial advisors understand Health Information Technology [HIT]. In truth, it is often economically misused or financially misunderstood. Moreover, an emerging national HIT architecture often puts the financial advisor or financial planner in a position of maximum uncertainty and minimum productivity regarding issues like: Electronic Medical Records [EMRs] or Electronic Health Records [EHRs], mobile health, tele-health or tele-medicine, Artificial Intelligence [AI], benefits managers and human resource professionals.
Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.
How to Start Learning and Earning Recognition for Your Knowledge
Now that you’re familiar with Micro-Credentialing, you might consider earning a Micro-Certification with us. We offer 3 official Micro-Certificates by completing a one month online course, with a live instructor consisting of twelve asynchronous lessons/online classes [3/wk X 4/weeks = 12 classes]. The earned official completion certificate can be used to demonstrate mastery of a specific skill set and shared with current or future employers, current clients or medical niche financial advisory prospects.
Mini-Certification Tuition, Books and Related Fees
The tuition for each Mini-Certification live online course is $1,250 with the purchase of one required dictionary handbook. Other additional guides, white-papers, videos, files and e-content are all supplied without charge. Alternative courses may be developed in the future subject to demand and may change without notice.
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Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at: MarcinkoAdvisors@msn.com [24/7] -OR- 770-448-0769[9:00 – 5:00 EST].
Posted on December 5, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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DEFINITION: Income is the money you receive in exchange for your labor or products. Income may have different definitions depending on the context—for example, taxation, financial accounting, or economic analysis. For most people, income is their total earnings in the form of wages and salaries, the return on their investments, pension distributions, and other receipts. For businesses, income is the revenue from selling services, products, and any interest and dividends received with respect to their cash accounts and reserves related to the business. Economists have different definitions of income and different ways of measuring it, from focusing on earnings, savings, consumption, production, public finance, capital investment or other topics … Maybe?
WASHINGTON (Reuters) – The U.S. Supreme Court is set on Tuesday to consider a challenge to the legality of a tax targeting owners of foreign corporations that could undermine efforts at imposing a wealth tax on the very rich in a case that has already sparked controversy over a call for Justice Samuel Alito to recuse.
The justices are due to hear arguments in an appeal by Charles and Kathleen Moore – a retired couple from Redmond, Washington couple – of a lower court’s decision rejecting their challenge to the tax on foreign company earnings, even though those profits had not been distributed.
The one-time “mandatory repatriation tax” (MRT), which applied to taxpayers owning at least 10% of certain foreign corporations, was part of a 2017 Republican-backed tax bill signed into law by former President Donald Trump.
At issue in the case is whether this levy on unrealized gains is allowed under the U.S. Constitution’s 16th Amendment, which enabled Congress to “collect taxes on incomes.” The Moores, backed by the Competitive Enterprise Institute and other conservative and business groups, contend that “income” means only those gains that are realized through payment to the taxpayer, not a mere increase in the value of property.
Posted on November 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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DEFINITION: In the USA shutdowns occur when funding legislation required to finance the Federal Government is not enacted before the next fiscal year begins. In a shutdown, the federal government curtails agency activities and services, ceases non-essential operations, furloughs non-essential workers, and retains only essential employees in departments that protect human life or property. Shutdowns can also disrupt state, territory and local levels of government.
Fortunately, prices held steady for consumers and are growing at a slower pace, the U.S. government just reported Tuesday morning, as overall prices in October were the same as what consumers paid in September.
The Bureau of Labor Statistics says prices in October were unchanged as gasoline prices declined and shelter costs continued to rise. The Consumer Price Index rose 3.2% compared to a year ago, the latest sign that inflation is slowing down as interest rates rise and the job market gives up some of its recent strength.
And, the stock markets rocked upward as Presidents Biden and Xi meet in San Francisco and Congress counts down toward a possible government shutdown. As stocks were a mixed bag yesterday as investors kept their eyes trained on Washington for the latest inflation good news data and to see whether lawmakers can hammer out a budget deal to keep the government from shutting down on Friday.
Yet, Boeing stock took off following reports that China may soon end its freeze on the 737 Max, as well as the announcement of several deals for new aircraft, including Emirates’s $52 billion order for 95 planes.
Do you ever wish you could acquire specific information for your career activities without having to complete a university Master’s Degree or finish our entire Certified Medical Planner™ professional designation program? Well, Micro-Certifications from the Institute of Medical Business Advisors, Inc., might be the answer. Read on to learn how our three Micro-Certifications offer new opportunities for professional growth in the medical practice, business management, health economics and financial planning, investing and advisory space for physicians, nurses and healthcare professionals.
Micro-Certification Basics
Stock-Brokers, Financial Advisors, Investment Advisors, Accountants, Consultants, Financial Analyists and Financial Planners need to enhance their knowledge skills to better serve the changing and challenging healthcare professional ecosystem. But, it can be difficult to learn and demonstrate mastery of these new skills to employers, clients, physicians or medical prospects. This makes professional advancement difficult. That’s where Micro-Certification and Micro-Credentialing enters the online educational space. It is the process of earning a Micro-Certification, which is like a mini-degree or mini-credential, in a very specific topical area.
Micro-Certification Requirements
Once you’ve completed all of the requirements for our Micro-Certification, you will be awarded proof that you’ve earned it. This might take the form of a paper or digital certificate, which may be a hard document or electronic image, transcript, file, or other official evidence that you’ve completed the necessary work.
Uses of Micro-Certifications
Micro-Certifications may be used to demonstrate to physicians prospective medical clients that you’ve mastered a certain knowledge set. Because of this, Micro-Certifications are useful for those financial service professionals seeking medical clients, employment or career advancement opportunities.
Examples of iMBA, Inc., Micro-Certifications
Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:
1. Health Insurance and Managed Care: To keep up with the ever-changing field of health care physician advice, you must learn new medical practice business models in order to attract and assist physicians and nurse clients. By bringing together the most up-to-date business and medical prctice models [Medicare, Medicaid, PP-ACA, POSs, EPOs, HMOs, PPOs, IPA’s, PPMCs, Accountable Care Organizations, Concierge Medicine, Value Based Care, Physician Pay-for-Performance Initiatives, Hospitalists, Retail and Whole-Sale Medicine, Health Savings Accounts and Medical Unions, etc], this iMBA Inc., Mini-Certification offers a wealth of essential information that will help you understand the ever-changing practices in the next generation of health insurance and managed medical care.
2. Health Economics and Finance: Medical economics, finance, managerial and cost accounting is an integral component of the health care industrial complex. It is broad-based and covers many other industries: insurance, mathematics and statistics, public and population health, provider recruitment and retention, health policy, forecasting, aging and long-term care, and Venture Capital are all commingled arenas. It is essential knowledge that all financial services professionals seeking to serve in the healthcare advisory niche space should possess.
3. Health Information Technology and Security: There is a myth that all physician focused financial advisors understand Health Information Technology [HIT]. In truth, it is often economically misused or financially misunderstood. Moreover, an emerging national HIT architecture often puts the financial advisor or financial planner in a position of maximum uncertainty and minimum productivity regarding issues like: Electronic Medical Records [EMRs] or Electronic Health Records [EHRs], mobile health, tele-health or tele-medicine, Artificial Intelligence [AI], benefits managers and human resource professionals.
Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.
How to Start Learning and Earning Recognition for Your Knowledge
Now that you’re familiar with Micro-Credentialing, you might consider earning a Micro-Certification with us. We offer 3 official Micro-Certificates by completing a one month online course, with a live instructor consisting of twelve asynchronous lessons/online classes [3/wk X 4/weeks = 12 classes]. The earned official completion certificate can be used to demonstrate mastery of a specific skill set and shared with current or future employers, current clients or medical niche financial advisory prospects.
Mini-Certification Tuition, Books and Related Fees
The tuition for each Mini-Certification live online course is $1,250 with the purchase of one required dictionary handbook. Other additional guides, white-papers, videos, files and e-content are all supplied without charge. Alternative courses may be developed in the future subject to demand and may change without notice.
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Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at: MarcinkoAdvisors@msn.com [24/7] -OR- 770-448-0769[9:00 – 5:00 EST].
John English, of the Ford Foundation, once observed that:
[T]he thing that is most interesting to me is that every one of the managers is able to give me a chart that shows me he was in the first quartile or the first decile. I have never had a prospective manager come in and say, ‘We’re in the fourth quartile or bottom decile’.
According to Wayne Firebaugh CPA, CFP® CMP™ most medical endowment funds today, even those with internal investment staff, rely heavily upon consultants and external managers.
In fact, a 2006 Commonfund Benchmarks Healthcare Study revealed that 85% of all surveyed institutions relied upon consultants with an even greater percentage of larger endowments relying upon consultants. The common reasons given by endowments for such reliance are augmenting staff and oddly enough, cost containment. In essence, the endowment staff’s job becomes one of managing the managers.
Manager Selection
Even those endowments that use consultants to assist in selecting outside managers remain involved in the selection and monitoring process. Interestingly, performance should generally not be the overriding criterion for selecting a manager. Selecting a manager could be viewed as a two-step process in which the endowment first establishes its initial allocation and determines what classes will require an external manager. The second part of the process is to select a manager that due diligence has indicated to have two primary characteristics: integrity and a repeatable and sustainable systematic process. These characteristics are interrelated, as a manager who embodies integrity will also strive to follow the established investment selection process.
Of Medical-Managers
In medicine, obtaining the best care often means consulting a specialist. As a manager of managers, the average endowment should seek specialist managers within a given asset class. Just as physicians and healthcare institutions gain additional insight and skill in their area of specialty, investment managers may be able to gain informational or system advantages within a given concentrated area of investments.
Assessment
Since most plan managers are seeking positive alpha by actively managing certain asset classes, many successful endowments will use a greater number of external managers in the concentrated segments than they will in the larger, more efficient markets.
Conclusion
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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
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Several years ago a group of highly trusted and deeply experienced financial services professionals and estate planners noted that far too many of their mature physician clients, using traditional stock brokers, management consultants and financial advisors, seemed to be less successful than those who went it alone. These Do-it-Yourselfers [DIYs] had setbacks and made mistakes, for sure. But, the ME Inc doctors seemed to learn from their mistakes and did not incur the high management and service fees demanded from general or retail one-size-fits-all “advisors.”
In fact, an informal inverse relationship was noted, and dubbed the “Doctor Effect.” In others words, the more consultants an individual doctor retained; the less well they did in all disciplines of the financial planning and medical practice management, continuum.
Of course, the reason for this discrepancy eluded many of them as Wall Street brokerages and wire-houses flooded the media with messages, infomercials, print, radio, TV, texts, tweets, and internet ads to the contrary. Rather than self-learn the basics, the prevailing sentiment seemed to purse the holy grail of finding the “perfect financial advisor.” This realization was a confirmation of the industry culture which seemed to be: Bread for the advisor – Crumbs for the client!
And so, at D.E. Marcinko & Associates, our informed cadre’ of technology focused and highly educated doctors, nurses, financial advisors, attorneys, accountants, psychologists and educational visionaries decided there must be a better way for healthcare colleagues to receive financial planning advice, products and related management services within a culture of fiduciary responsibility.
We trust you agree with this ME Inc, and Certified Medical Planner™ consulting philosophy, as illustrated on our website.
Did you know that at MARCINKO & Associates, all medical colleagues throughout the United States may contact us when they are considering the sale, purchase, strategic operating improvement, merger, acquisition and/or other financial business or related personal financial planning transaction?
Our difference is “hard” knowledge and insider financial guidance that helps medical colleagues, nurses, private practitioners, clinics, ambulatory surgery, radiology and outpatient wound care centers realize their ultimate economic goals. This typically includes managerial and cost accounting, financial ratio analysis, fair market valuation business appraisals, business plan creation and personal financial planning.
Our “expert witness” business litigation support service and divorce mediation, arbitration, asset division, settlement and second opinion offerings are always available, as well.
And, our “soft” skill professional career guidance and mentoring center includes executive coaching, consulting and mentoring advisory programs for stressed, conflicted or burned-out physicians and medical practitioners.
Most importantly, our professional fees are reasonable and always transparent.
MARCINKO & Associates also serves universities, medical, business, graduate and nursing schools; physicians, dentists, podiatrists, optometrists and legal societies. This includes accountants, financial service providers, wealth and hedge fund managers, emerging entities, hospitals, CEOs and their BODs, the press, media and related organizations.
Did you know that at MARCINKO & Associates, all medical colleagues throughout the United States may contact us when they are considering the sale, purchase, strategic operating improvement, merger, acquisition and/or other financial business or related personal financial planning transaction?
Our difference is “hard” knowledge and insider financial guidance that helps medical colleagues, nurses, private practitioners, clinics, ambulatory surgery, radiology and outpatient wound care centers realize their ultimate economic goals. This typically includes managerial and cost accounting, financial ratio analysis, fair market valuation business appraisals, business plan creation and personal financial planning.
Our “expert witness” business litigation support service and divorce mediation, arbitration, asset division, settlement and second opinion offerings are always available, as well.
And, our “soft” skill professional career guidance and mentoring center includes executive coaching, consulting and mentoring advisory programs for stressed, conflicted or burned-out physicians and medical practitioners.
Most importantly, our professional fees are reasonable and always transparent.
MARCINKO & Associates also serves universities, medical, business, graduate and nursing schools; physicians, dentists, podiatrists, optometrists and legal societies. This includes accountants, financial service providers, wealth and hedge fund managers, emerging entities, hospitals, CEOs and their BODs, the press, media and related organizations.
Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
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