NEWEST THOUGHTS: Physician Personal Emergency Fund Size is Getting Complicated

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By Dr. David Edward Marcinko MBA MEd

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It has been said that most ordinary people should have at least three to six months of living expenses (not including taxes) in a cash-equivalent reserve fund that is easily accessible (i.e., liquid).  The amount needed for a one-month reserve is equal to the amount of expenses for the month, rather than the amount of monthly income. This is because during no-income months there is no income tax.  

However, the situation might not be the same for physicians in today’s harsh economic climate. 

The New Realities

Now, some physician-focused financial advisors, financial planners and Certified Medical Planners™ suggest even more reserve fund savings; up to two years. That’s because many factors come into play when determining how much a particular doctor’s family should have.

For example: 

  • Does the family have one income or two? If the doctor is in a dual-income family with stable incomes and they live on a single income, the need for a liquid reserve is less.  
  • How stable is the doctor’s income source? If a sole provider with an unstable income who spends all of the income each month, the need for a liquid cash reserve is high. 
  • Does the doctor own the practice, work in a clinic, medical group, hospital or healthcare system? In other words – employee (less control) or employer (more control). 
  • What is the doctor’s medical specialty and how has managed care penetrated his locale, or affected her focus? What about a DO, DDS/DMD or DPM, etc.
  • How does the family use its income each month; does it have a saver, spender, or investor mentality?  
  • Does the family anticipate the possibility of large expenses occurring in the future (medical practice start-up costs or practice purchase; children, medical school student debts; auto or home loans; and/or liability suits, etc)?  
  • Pan physician lifestyle?

The Past 

In the ancient past, a doctor may have opted for a nine-twelve month reserve if the need for security was high – and a six-to-nine month reserve if the need for security was low. But today, even more may be needed.  How about 15-18 months, or more? Perhaps even 24 months!

So, the following questions may be helpful in determining the amount of reserve needed by the physician: 

1. How long would it take you to find another job in your medical specialty if you suddenly found yourself unemployed – same for your spouse?

2. Would you have to relocate – same for your spouse? 

3. How much do you spend each month on fixed or discretionary expenses and would you be willing to lower your monthly expenses if you were unemployed? 

Assessment

Once the amount of reserve is determined, the doctor should use the appropriate investment vehicles for the funds. 

At minimum, the reserve should be invested in a money market fund. For larger reserves, an ultra-short-term bond fund might be appropriate for amounts over three-six months. While even larger reserves might be kept in a short term bond fund depending on interest rates and trends. 

So, what do the initials M.D. really mean? … More Dough!

How much reserve do you have and where is it stashed?

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INVESTING Psychology

By Dan Ariely PhD

THE IRRATIONAL ECONOMIST

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Of course you don’t need a human financial advisor … until you do. Today, we’ve had unfettered internet access to a wide range of investments, opinions and models for at least two decades. So, why the bravado to go it alone; fifteen positive years for equities, since 2009! Yet, the DJIA, S&P 500 and NASDAQ just plunged and plummeted today!

The financial advisor’s role is to remove the human element and emotion from investing decisions for something as personal as your wealth. Emotion drives the retail investor to sell low (fear) and buy high (greed). This is the reason why the average equity returns for retail investors is less than half of the S&P 500’s returns.

No, of course you don’t need a human financial advisor … until you do.

And when you do, it may be too late.

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PARADOX: Obsessing About Security Breeds Insecurity?

Human life is Inherently Insecure

By Staff Reporters

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The desire for security and feelings of insecurity are the same thing.

The idea of security, financial or otherwise, is an illusion; human life is inherently insecure.  But, this doesn’t mean we shouldn’t be prudent with risk and diligent financial planning with strategies like saving and investing.

However, according to colleague Eugene Schmuckler PhD, MBA, MEd seeking security is like many things; the more you try to grasp and obsess about financial security, the more quickly you will reach a point of diminishing returns. You will feel increasingly less secure at a certain point.

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DJT EXECUTIVE ORDER: US Sovereign Wealth Fund Created

Trump orders creation of US sovereign wealth fund

BREAKING NEWS

By Staff Reporters

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What Is a Sovereign Wealth Fund (SWF)?

A Sovereign Wealth Fund (SWF) is a large pool of capital managed by a country’s government to achieve specific economic and social goals. These funds are invested in various assets such as stocks, bonds, real estate, commodities, and other financial instruments.

SWFs are typically funded from the savings of state-owned enterprises, foreign currency reserves from central banks, or commodity exports. The size and composition of each SWF can vary significantly between countries based on their respective economic circumstances. Each country has various reasons for setting up an SWF. However, the most common purpose of establishing one is to diversify and protect a country’s economy. For instance, this fund can be used as emergency reserves for potential future global financial shocks.

Purpose of a Sovereign Wealth Fund

Sovereign wealth funds invest a country’s wealth to achieve the government’s economic and social objectives. These funds provide countries with an additional method to diversify their economies and reduce risk exposure. They also give governments a chance to invest in global markets outside their own countries, which can get them better returns on their investments. This increases the earning potential on foreign exchanges and provides additional economic stability.

Furthermore, SWFs are a valuable tool to help countries build up buffers and savings for future generations to be better prepared for future economic shocks. Proper use of SWFs leads to long-term economic growth and stability.

In addition to providing an alternative form of investment for governments and enterprises worldwide, SWFs have also been used to increase financial transparency and accountability in many countries. By making their investment decisions public, these funds help promote corporate governance standards across the globe. This encourages market stability and reduces risks associated with certain types of investments.

MORE: https://www.financestrategists.com/financial-advisor/sovereign-wealth-fund-swf/

TRUMP: https://www.reuters.com/markets/wealth/trump-signs-executive-order-create-sovereign-wealth-fund-2025-02-03/

TRUMP: https://www.usnews.com/news/top-news/articles/2025-02-03/trump-signs-executive-order-to-create-sovereign-wealth-fund

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AUSTERITY: Financial Measures

By Staff Reporters

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Austerity Financial Measures describe official actions (typically taken under duress) by financially challenged governments (those that are under the threat of otherwise not being able to meet all of their obligations to debt holders and other creditors) to reduce the amount of money they spend, freeing more of it for paying off liabilities.

Austerity measures commonly involve deficit cutting, reduced spending, and cuts in government benefits and services provided. They are considered a “necessary evil,” along with revenue-raising measures, for bringing government budgets back into financial balance.

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SALARY PRIME NUMBERS: Financial Success by Generation

By Staff Reporters

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According to HVL from Morning Brew, a new survey from financial services company Empower ignited a conversation about what monetary success means. Turns out, it depends on who you ask. Boomers believe that success means having an annual salary of about $100,000. Gen Z thinks your mom can’t brag about you to her dentist until you earn $600k/year. On average, respondents said success is making $270,000 annually.

Additionally, less than 40% of respondents said they considered themselves financially successful. Almost 50% don’t believe they will achieve the level of success they desire.

But there was some good news: Forty-three percent said their idea of success didn’t depend on a specific sum of money. And almost 60% said happiness is most important, as long as happiness is defined as “being able to spend money on the things and experiences that bring the most joy.”

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PHYSICIAN FINANCIAL FEAR: Money Anxiety & Chrometophobia

By Dr. David Edward Marcinko MBA MEd

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If you’ve found yourself worrying about the stock market or money lately, you definitely have company. Money anxiety, also called financial anxiety, has become more common than ever after the presidential election of November 2024.

In fact, the American Psychological Association’s 2022 Stress in America Survey, 87 percent of people who responded listed inflation as a source of significant stress. The rise in prices for everything from fuel to food has people from all backgrounds worried, today. The researchers say, in fact, that no other issue has caused this much stress since the survey began in 2007.

When money and financial concerns cause ongoing stress in your life, you could eventually begin to experience some feelings of anxiety as a result. This anxiety can, in turn, have a negative impact on your quality of life.

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Chrometophobia, commonly known as fear of money, is a psychological condition characterized by overwhelming anxiety and avoidance of currency; according to colleague Dan Ariely PhD.

CITE: https://www.r2library.com/Resource/Title/0826102549

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Physician Financial Fear is probably the most common emotion among physicians. The fear of being wrong – as well as the fear of being correct! It can be debilitating, as in the corollary expression on fear: the paralysis of analysis.

According to Paul Karasik, there are four common investor and physician fears, which can be addressed by financial advisors and psychologists in the following manner:

  • Fear of making the wrong decision: ameliorated by being a teacher and educator.
  • Fear of change: ameliorated by providing an agenda, outline and/or plan.
  • Fear of giving up control: ameliorated by asking for permission and agreement.
  • Fear of losing self-esteem: ameliorated by serving the client first and communicating that sentiment in a positive manner.

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NINE: Psychological Reasons We Do Dumb Things with Money [$$$$]

Yep – Even the Smart Folks!

By Lon Jefferies MBA CMP® CFP®

Dr. David Edward Marcinko MBA MEd CMP®

Lon Jeffries

In the Business Insider, Mandi Woodruff describes nine mental blocks that cause smart people to do dumb things. Review the list and itemize the factors that have negatively impacted your finances.

The Factors

  • Anchoring happens when we place too much emphasis on the first piece of information we receive regarding a given subject. For instance, when shopping for a wedding ring a salesman might tell us to spend three months’ salary. After hearing this, we may feel like we are doing something wrong if we stray from this advice, even though the guideline provided may cause us to spend more than we can afford.
  • Myopia (or nearsightedness) makes it hard for us to imagine what our lives might be like in the future. For example, because we are young, healthy, and in our prime earning years now, it may be hard for us to picture what life will be like when our health depletes and we know longer have the earnings necessary to support our standard of living. This short-sightedness makes it hard to save adequately when we are young, when saving does the most good.
  • Gambler’s fallacy occurs when we subconsciously believe we can use past events to predict the future. It is common for the hottest sector during one calendar year to attract the most investors the following year. Of course, just because an investment did well last year doesn’t mean it will continue to do well this year. In fact, it is more likely to lag the market.
  • Avoidance is simply procrastination. Even though you may only have the opportunity to adjust your health care plan through your employer once per year, researching alternative health plans is too much work and too boring for us to get around to it. Consequently, we stick with a plan that may not be best for us.
  • Confirmation bias causes us to place more emphasis on information that supports the opinion we already have. Consequently, we tend to ignore or downplay opinions that don’t mirror our own, leading us to make uninformed decisions.

NOTE: An interesting example of the confirmation bias is the case of David Rosenberg, who is one of the most well-known perpetual bears on Wall Street. In October, Mr. Rosenberg’s analysis forced him to warm to the current investment environment. His fans and followers, rather than appreciating his research and ability to adjust to new information, criticized him for changing his opinion.

As it turned out Mr. Rosenberg had fans not because of his expert analysis, but because he added intellectual heft to his followers pessimism and quasi-political desire for the system to collapse. Their view was that things were in permanent decline and his analysis, charts, and voice added respectability to their pre-existing bias. Mr. Rosenberg has now lost his fan base not because he was wrong for the last four years, but because he changed his mind.

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  • Loss aversion affected many investors during the crash of 2008. During the crash, many people decided they couldn’t afford to lose more and sold their investments. Of course, this caused the investors to sell at market troughs and miss the quick, dramatic recovery.
  • Overconfident investing happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. Data convincingly shows that people who trade most often underperform the market by a significant margin over time.
  • Mental accounting takes place when we assign different values to money depending on where we get it from. For instance, even though we may have an aggressive saving goal for the year, it is likely easier for us to save money that we worked for than money that was given to us as a gift.
  • Herd mentality makes it very hard for humans to not take action when everyone around us does. For example, we may hear stories of people making significant profits buying, fixing up, and flipping homes and have the desire to get in on the action, even though we have no experience in real estate.

Assessment

The good news is that being aware of these tendencies can help us avoid mistakes. We’ll never be perfect, but avoiding detrimental decisions based on mental prejudices can give us an advantage in our financial and retirement planning efforts.

Conclusion

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ECONOMICS: Price Gouging VS. Supply & Demand

NEBULOUS DEFINITIONS

By Staff Reporters

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The simplest model of a market involves two things, supply and demand, and the price and quantity of the goods sold in the market are a function of both. When a natural disaster hits like Hurricane Helene, the immediate effect can be two-fold. In such situations, it is not unusual that the demand for certain products may increase. For example, if everyone is trying to leave the area, demand for gas may rise. The other effect is that supply for certain products may decrease. And, it may be more costly to transport gas in areas affected by a natural disaster, thus decreasing the supply of gas and in turn, increasing the price.

CITE: https://www.r2library.com/Resource

When supply decreases, the price of the good increases. And when demand increases, again the price of the good increases. So we would predict that the market price of gas, for example, would increase in areas recently affected by a hurricane. And in fact we do see this.

Price-gouging occurs when companies raise prices to unfair levels. There is no rule for what qualifies as price-gouging, but it is not an uncommon occurrence. For example in medicine, EpiPen costs is a current example of price increases that have been labeled unfair. 

Note: An epinephrine auto-injector (or adrenaline auto-injector, also known by the trade mark EpiPen) is a medical device for injecting a measured dose or doses of epinephrine (adrenaline) by means of auto-injector technology. It is most often used for the treatment of anaphylaxis. The first epinephrine auto-injector was brought to market in 1983.

Cite: https://tinyurl.com/55kmum86


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The M1 and M2 Money Supply

By Staff Reporters

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DEFINITION: In macro-economics, the money supply (or money stock) refers to the total volume of currency held by the public at a particular point in time. There are several ways to define “money”, but standard measures usually include currency in circulation (i.e. physical cash) and demand deposits (depositors’ easily accessed assets on the books of financial institutions . The Central Bank [FOMC] of a country may use a definition of what constitutes legal tender for its purposes.

CITE: https://www.r2library.com/Resource

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Though there are a few variations of money supply, most economists tend to focus on M1 and M2. The former takes into account cash and coins in circulation, as well as demand deposits in checking accounts and traveler’s checks. In other words, money that’s either in your hand or can be accessed very easily.

Meanwhile, M2 accounts for everything in M1 and adds savings accounts, money market funds, and certificates of deposit (CDs) below $100,000. It’s money you have access to, but it takes a little extra effort to put this capital to work. It’s M2 money supply that’s raising eyebrows on Wall Street and making history.

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What’s of interest is what’s happened to M2 money supply over the trailing year. Following a peak of $21.7 trillion in July 2022, M2 has fallen to a fresh reading of $20.81 trillion, as of May 2023. Although the May reading was higher than April and broke a nine-month downtrend, we’ve still witnessed a 4.1% aggregate drop in M2 from its all-time high. 

Considering that M2 enjoyed a historic expansion during the pandemic, it’s certainly possible that a 4.1% decline can be shrugged off as nothing more than money supply reverting back to the mean. But history suggests otherwise.

Though history rarely repeats itself on Wall Street, it often rhymes. We haven’t seen a meaningful year-over-year decline in M2 money supply since the Great Depression in 1933.

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And so, based on what we’re seeing from M2 money supply, commercial bank lending, and domestic banks tightening their lending standards for C&I loans, the ingredients for a U.S. recession are most definitely there. Stock losses have, historically, been most pronounced in the months that follow the official declaration of a recession by the eight-economist panel of the National Bureau of Economic Research.

However, Wall Street’s performance is largely dependent on your investment time frame. If you’re patient, these and other potentially worrisome money metrics represent nothing more than temporary white noise.

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KING IS CASH: In a Tough Interest Rate Ecosystem

By Staff Reporters

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Cash is king, especially in this tough interest rate environment. That’s proving true in the mergers and acquisitions market this year, according to PwC’s US Deals 2023 midyear outlook, which says companies and private equity with cash in hand are making deals happen. There are “opportunities for corporates with strong balance sheets. Private equity sponsors with large amounts of dry powder also have been getting deals done,” according to PwC.

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Deal makers need cash because lending has become tougher and more expensive to obtain. Additionally, “the IPO market has remained quiet for over a year.”

Even the private equity market, which often leans heavily on debt financing, is reaching for other ways to get deals done: “Some PE sponsors have turned to more creative financing solutions, including higher equity contribution, seller’s notes, paid in-kind financing and the private credit markets.”

The challenging market is also impacting deal size. PwC found that deal makers are eschewing big deals in favor of smaller opportunities. However, although the deals appear to be smaller, the volume of M&A activity is “relatively strong compared toCOVID pre-pandemic levels.

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MONEY FACTS: To Know and Enjoy!

By Jon Dulin

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After burning the midnight oil and reading through the National Archives, I have the following money facts I know you will enjoy.

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ELECTIONS: Money and Markets

Historical Review

By Staff Reporters

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Now that the voting is behind us, it might be safe to start checking your portfolio. In recent history, stocks have only gone up after midterm elections:

  • In the year following every midterm election since 1950, the S&P 500 has risen—no matter which party won.
  • A divided government, which could happen if the GOP retakes at least the House, delivers the best market results: Data going back to 1932 shows average annual S&P returns of 13% when there’s a GOP-controlled Congress under a Democratic president, compared to 10% when Democrats have both, per RBC Capital Markets.

Why?

There’s some debate, but partisan gridlock can be advantageous for business because it minimizes the chance of major changes to taxes or other laws that impact companies. It also doesn’t hurt to have the uncertainty of the election in the rear-view mirror.

Right now however, investors are more focused on the FOMCs’ rate hikes in response to inflation. While politicians from both sides of the aisle have criticized Jerome Powell’s recent decisions, he’s unlikely to change course due to the election outcome. Plus, economists seem pretty convinced the US is headed toward a recession, regardless of who’s in control in Washington.

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What is the right relationship to money?

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Money often costs too much.

-Ralph Waldo Emerson

By Gus: https://www.wisedrugged.com

Presented By J. Krishnamurti

As the Dow Jones soars to new peaks, it seems many of us feel a sense of security within the realm of money.

Less preoccupation maybe? Is th…

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Money

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What is the right relationship to money? presented by J. Krishnamurti

Conclusion

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Physicians and Money

A Commencement Address on “Positive Deviancy”

Staff Reporters

money1One June 12th, 2009, New Yorker staff writer Atul Gawande MD delivered this commencement address, titled “Money,” to the graduates of the University of Chicago; Pritzker School of Medicine. It expands on the themes he touched on in his recent article about health-care costs in McAllen, Texas, which figures in President Obama’s vision on health care reform. 

 

 

Link: http://www.newyorker.com/online/blogs/newsdesk/2009/06/atul-gawande-university-of-chicago-medical-school-commencement-address.html

Related posts at KevinMD.com

  1. “A board-certified, internal-medicine physician makes $7 more an hour than a hairstylist”
  2. Will universal health care lead to a physician shortage?
  3. Does preventive medicine really save money?

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