BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Markets: Stocks slid lower today even as a preliminary survey revealed that consumer sentiment hit its highest point since February, while inflation expectations fell to pre-tariff levels. The selloff deepened on reports that President Trump wants 15% to 20% tariffs against the EU, though the NASDAQ managed to eke out a win.
Crypto: Although bitcoin fell after the president signed the GENIUS Act into law, ether rose to its highest price in six months today, while enthusiasm for the new legislation pushed total crypto assets above $4 trillion.
Stocks: Markets started the day on a high note thanks to a fifth straight decline in weekly initial jobless claims and surprisingly strong monthly retail sales. The NASDAQ hit its 10th record closing high of 2025 and the S&P 500 hit its ninth high.
Commodities: Lithium prices popped around the globe after the Chinese government ordered domestic producer Zangge Mining to halt operations. Plus, the US is reportedly set to impose 93.5% tariffs on Chinese imports of graphite, a key component.
The Fed Drama: A White House official said President Trump will likely fire Jerome Powell soon. Stockssank at the thought of the Fed head being shown the door, offsetting the pleasant surprise of a flat wholesale inflation reading.
Markets: Stocks managed to recoup their losses after Trump said it’s “highly unlikely” that he will fire Powell, but bonds remained shaken.
Crypto: Bitcoin bounced higher after the crypto bills currently under consideration in the House of Representatives cleared a key hurdle.
Posted on July 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Stocks: Markets shrugged off President Trump’s weekend threat of 30% levies against the EU and Mexico, as well as his proposed 100% secondary tariffs against Russia today. Stocks eked out a win across the board, with the NASDAQ climbing to a new record close.
Commodities: Oil prices fell while gold took a breather, but the big winner was orange juice futures, which hit a four-month high thanks to Trump’s promise of 50% tariffs on all imports from Brazil. Coffee prices also climbed.
Overconfident Investing Bias happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. This causes the results of a study to be unreliable and hard to reproduce in other research settings.
Example: Data convincingly shows that people and financial planners/advisors and wealth managers who trade most often under-perform the market by a significant margin over time. Active traders lose money.
Example: Overconfidence Investing Bias moreover leads to: (1) excessive trading (which in turn results in lower returns due to costs incurred), (2) underestimation of risk (portfolios of decreasing risk were found for single men, married men, married women, and single women), (3) illusion of knowledge (you can get a lot more data nowadays on the internet) and (4) illusion of control (on-line trading).
Stocks: The major Wall Street stock indexes languished. The S&P pulled back from its record high to close the week just a bit lower, but the NASDAQ managed to post a gain across the week.
Crypto: Bitcoin hit a new high-water mark above $118,000. Next week, July 14th, Congress hosts “Crypto Week” to discuss regulating the industry in a growth-oriented manner.
Commodities: Silver rose to its highest level since 2011, and it’s been even hotter than gold. The metal is up ~27% this year. Oil, meanwhile, ticked higher on speculation that President Trump will place more sanctions on Russia early next week.
Stocks: Jobless claims came in lower than expected, the 30-year US bond auction met with strong demand, and Delta Airlines unofficially kicking off earnings season with a solid report. The S&P 500 and the NASDAQhit record highs.
Crypto: Bitcoin reached a record high for the second day in a row, hitting $113,863.31 today. The crypto’s price has stayed above $100k for 60 consecutive days.
Commodities: Coffee futures in New York climbed as much as 3.5% in response to President Trump’s threat to slap 50% tariffs on Brazil, which is the top producer of higher-end arabica coffee.
Posted on July 10, 2025 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.
Hims & Hers Health gained 4.62% after announcing it will sell generic semaglutide in Canada when Novo Nordisk’s patent for Ozempic and Wegovy expires in January.
Merck shareholders applauded its move to buy respiratory drugmaker Verona Pharma for $10 billion, sending its stock up 2.88%.
Rhythm Pharmaceuticals popped 36.63% thanks to a promising new trial for its oral obesity treatment.
AES, a renewable power company that counts Microsoft among its clients, jumped 19.87% after Bloomberg reported it was considering a sale.
Fashion names Ralph Lauren (+2.10%) and Coach owner Tapestry (+3.31%) hit record highs.
Stocks down
WPP cut its guidance and watched its stock fall 18.11% as a result. The ad giant is dealing with a laundry list of challenges, from AI disrupting the industry to clients spending less to finding a new CEO.
Medical device maker RxSight plunged 37.84% after slashing its full-year revenue forecast.
T-Mobile ticked 1.55% lower after getting a downgrade from KeyBanc, which said its weakness in fiber internet would prevent it from catching up to rival AT&T.
Mobileye, which makes self-driving tech and was spun out of Intel, fell 7.08% when Intel said it was selling 45 million shares.
Stocks: The major indexes plowed higher with the minutes of the last FOMC meeting showing that officials were not at all united about when to begin cutting rates. Investors also treated more tariff letters sent by President Trump to seven more countries including Iraq and the Philippines as not vital.
Bonds: US Treasuries snapped a five-day losing streak after a $39 billion sale of 1-year notes was met with solid demand.
Posted on July 9, 2025 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.
Record VC investments for women’s health: Venture-backed women’s health startups experienced unprecedented investment last year, according to a new SVB report. The report examines the factors driving such record-breaking funding—like growing recognition of how various health conditions affect women differently and disproportionately, plus the causes and biological drivers behind this imbalance. Read it here.
Stocks: Investors mostly yawned and the major indexes held steady a day after President Trump reignited his trade war by announcing higher tariffs would go into effect on 14 countries starting August 1st. Wall Street banks don’t seem concerned either, as Goldman Sachs and Bank of America became the latest strategists to raise their year-end target for the S&P 500.
Commodities: Copper futures popped as much as 17% to a new record, the largest intra-day gain since at least 1988, after Trump said he plans to place a 50% tariff on copper imports.
Posted on July 8, 2025 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.
The FBI has uncovered $14.6 billion worth of fraudulent claims submitted to Medicare, Medicaid and other government health care programs, the agency said on Monday in conjunction with the Department of Justice (DOJ). The investigation resulted in 324 defendants being charged, including 96 medical professionals.
Now, the DOJ, FBI and HHS say they are collaborating to create a health care data fusion center that will help them identify, investigate and prosecute health care fraud.
And yesterday, the entities announced a DOJ-HHS False Claims Act Working Group, in which HHS will refer potential False Claims Act violations to the DOJ. Read more about the working group, its members and its goals here.
Stocks: US equities tumbled from record highs, dragged down by megacaps, as President Trump reignited the dormant trade war with fresh tariff warnings against major trading partners (more on that in a sec). Meanwhile, the dollar bounced 0.5% against a basket of other currencies.
Commodities: Oil gained despite OPEC+ deciding to raise crude production by 548,000 barrels per day beginning in August, a larger-than-expected increase. Ultimately, Wall Street analysts expect oil futures to drop below $60 a barrel by the end of the year due to the increase in production.
Posted on July 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Stocks: Markets wrapped the trading day with another win thanks to a shockingly strong jobs report this morning. Both the S&P 500 and the NASDAQ hit new record highs.
Stocks: The S&P 500 and the NASDAQ started the second half of the year on the wrong foot, while the Dow climbed despite investors’ trepidation about conflict in Congress. But the Senate passed its version of the big, beautiful bill this afternoon, potentially getting us one step closer to ending all the drama.
Bonds: 10-year Treasury yields fell to their lowest level in two months this morning ahead of Jerome Powell’s appearance at a central banking conference today. There, Powell demurred on the possibility of a July rate cut, reiterating his wait-and-see approach.
Safe havens: The US dollar gained ground after a terrible first half of the year, while gold rose as investors braced themselves for the big jobs report on Friday.
Deals: Stocks popped at the open yesterday on the news that Canada has rescinded the digital services tax in order to lure the US back to the negotiating table. Meanwhile, Bloomberg reported that the EU will accept a 10% universal tariff in exchange for some key concessions.
Stocks: The S&P 500 and the NASDAQ both hit new record highs today, with the S&P 500 wrapping up its best quarter since Q4 20
The Fed: President Trump published a handwritten note asking Jerome Powell to cut interest rates, even as the White House considers new ways to replace the Fed Chair. Meanwhile, Goldman Sachs now sees the chances of the Fed cutting interest rates in September as “somewhat above 50%.”
Posted on June 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Deals: The US and China revealed the details of their trade deal framework, easing restrictions on rare earth metals and semiconductor chips. Commerce Secretary Howard Lutnick promised up to 10 more deals are on their way ahead of the July 9th tariff-pause deadline, but that probably won’t include Canada: President Trump ended all trade discussions with the country thanks to a dispute over the digital services tax.
Stocks: Indexes climbed at the open thanks to the deal with China, but they tumbled on news of a fallout with Canada. Still, the S&P 500 managed to post its 1,245th new all-time high, while the NASDAQ booked its own record close. The Dow trundled higher as well, though it’s still about 1,600 points below its previous record.
Posted on June 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BY A.I.
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Stocks: The S&P 500 briefly traded a few cents above its February all-time closing high yesterday afternoon, but couldn’t sustain the gain and fell just short at the end of the day. The NASDAQ remains inches away from its record high as well.
Deals: The end of the 90-day tariff pause is less than two weeks away, but the White House said that the July 9th deadline “is not critical.”
Meanwhile, the Treasury Department is doing everything it can to make the dreaded “revenge tax” in the big, beautiful bill irrelevant.
Commodities: Gold and oil had muted moves upward but copper climbed to a three-month high after Goldman Sachs analysts warned of shortages ahead
Posted on June 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: The S&P 500 and NASDAQ started the day inches away from their all-time highs, but the market rally faltered in mid-afternoon as relief from an Israel/Iran ceasefire faded and investors turned their attention to Friday’s PCE report.
Economy: Speaking of inflation, Jerome Powell stuck to his guns during his second day of congressional testimony, endorsing a wait-and-see mentality. President Trump is apparently tired of waiting, and says he has “3 or 4” candidates in mind to replace Powell.
Commodities: Oil bounced back after posting its biggest two-day decline since 2022.
Here is a list of the most common and helpful investment terms you’ll come across and should know.
Ask. The price that someone looking to sell stock wants to receive.
Bid. The price that someone is willing to pay for stock.
Buy. To acquire shares and thereby take a position in a company.
Sell. To get rid of shares whether because you’ve reached your goal or to prevent losses.
Bull market. Market conditions in which investors expect prices to rise.
Bear market. Market conditions in which investors expect prices to fall.
Dividend. A portion of a company’s earnings paid to shareholders.
Blue chip stocks. Shares of large and well-recognized companies that have a long history of solid financial performance.
Earning per share. A company’s net profit divided by the number of outstanding common shares.
Mutual fund. A collection of investments — stocks, bonds, commodities, and more — bundled together and held in common by a group of investors.
Asset. Something you own that could generate a return in the form of more assets.
Asset allocation. Your investment strategy, essentially — the mix of assets you choose to put your money into, whether that be cash, bonds, stocks, commodities, real estate or something else.
Broker. A person or firm — or robot — that arranges transactions between buyers and sellers in exchange for a commission (that is, a fee).
Capital gain (or capital loss). The money you make (or lose) on the sale of an asset.
Diversification. Investing in a variety of sectors, such as health care, energy and IT as well as across different geographic locations.
Dow Jones Industrial Average. A price-weighted list of 30 blue-chip stocks. It’s often used to help get a sense of the overall health of the stock market, even though it only reflects a small portion of the players.
Index fund. A type of mutual fund or exchange-traded fund that allows you to invest in a portfolio that mimics a market index, which is basically a list that tracks the performance of a group of investments either for a specific sector or the overall market.
Hedge fund. A type of investment partnership. Partners pool money from investors and try out a few different investing strategies. Generally, hedge funds will make riskier investments than your typical investor. They’ll also often use leverage (that is, borrowed money) or place bets against the market to get bigger returns. They make their money by charging their investors management fees based on a percentage of their profits.
Expense ratio. The percentage-based fee that mutual fund managers charge you to manage your investments.
Market price. How much it would cost right now to buy or sell an asset or service.
Securities and Exchange Commission (SEC). An independent government body that was created to protect investors and the national banking system. The SEC enforces laws that maintain orderly, fair and efficient markets.
Short selling. A tactic available to investors who predict a stock’s price is about to drop. An investor borrows a quantity of shares through a broker and then sells them, intending to repurchase them later, at a lower price, and return them to the lender.
Stock exchange. A place buyers and sellers come together to buy, sell and trade stock during set business hours. The New York Stock Exchange (NYSE) is the most important stock exchange in the world, but there are a total of 16 exchanges around the world.
Stock market. Refers in general to the collection of markets and exchanges where the buying, selling and trading of investment vehicles takes place.
Price per share. A simple way of calculating a company’s market value at a given moment. To find the price per share, you take a company’s most recent share price and multiply it by its total number of outstanding shares.
Prospectus. A legal document that contains in-depth information about anything you might be planning to invest in: stocks, bonds or mutual funds.
Posted on June 25, 2025 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.
SPACs, or special purpose acquisition companies, are shell companies that are created just to acquire or merge with an existing company, allowing that company to enter public markets without going through an IPO. The catch, however, is the SPAC sponsors have a small window of time—usually within two years—to find a suitable company to acquire.
Carnival popped 6.91% after the cruise line reported impressive earnings and reiterated its healthy financial guidance.
If you can’t beat ‘em, join ‘em: Mastercard rose 2.80% on the news that it will integrate Fiserv’s new stablecoin into its products. Fiserv gained 1.24%.
Lyft gained 6.09% after TD Cowen analysts upgraded the stock, calling the ride-sharing company their “Best SMIDcap Idea for 2025.”
Falling oil prices helped airline stocks soar today: Frontier Group jumped 7.56%, JetBlue Airways rose 4.15%, and American Airlines added 4.31%.
Ambarella soared 20.61% on reports that the chip designer may be exploring a sale.
Nektar Therapeutics exploded 156.29% thanks to strong results in the Phase 2 trial of its new eczema treatment.
Crypto miners rose as investors took on more risk following a ceasefire in the Middle East: CleanSpark climbed 13.45%, Riot Platforms rose 8.09%, and MARA Holdings gained 4.94%.
What’s down
Oil prices fell on news of a ceasefire between Israel and Iran, pulling oil stocks down with them: Exxon Mobil lost 3.04%, Chevron dropped 2.25%, and Occidental Petroleum fell 3.34%.
The ceasefire also sent defense contractors tumbling: Lockheed Martin lost 2.59%, RTX dropped 2.72%, and Northrup Grumman fell 3.20%.
Krispy Kreme fell 0.76% on the news that its deal with McDonald’s has fallen apart due to rising costs.
Posted on June 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Markets rose tentatively to start the week after the US bombed three nuclear facilities in Iran over the weekend. The rally gained steam in the afternoon after Iran launched a missile strike against a US airbase in Qatar, leaving no US casualties and keeping a path to de-escalation intact.
Safe havens: The US dollar rose to its highest level in nearly a month this morning, up from a three-year low last week, as investors sought safety. Meanwhile, gold inched higher despite pressure from a stronger dollar, a sure sign of investor tension.
Crypto: Bitcoin fell dangerously close to the key support level of $100,000 before recovering later in the day as traders took a risk-on stance.
Posted on June 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Markets: Stocks climbed yesterday as oil prices fell, with investors reacting positively to what appeared to be limited retaliation from Iran in response to the US bombing its nuclear facilities over the weekend.
Meanwhile, Tesla had its biggest jump in two months following the successful, albeit limited, rollout of its robotaxi service in Austin.
Posted on June 24, 2025 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.
Tesla climbed 8.23% thanks to a successful robotaxi debut in Austin this weekend
NorthernTrust popped 8.01% on reports that Bank of New York Mellon is considering acquiring the financial services company.
The stablecoin adoption wave continues to hit markets, with Fiserv up 4.38% after announcing it made deals with Circle and PayPal to roll out a stablecoin and digital-asset platform for banking clients. Circle climbed another 9.64%.
Nuclear energy stocks climbed on the news that New York will build the first major new US nuclear plant in more than 15 years. ConstellationEnergy rose 3.37%, while CentrusEnergy climbed 1.16% and UraniumEnergy gained 2.01%.
SpartanNash exploded 50.62% higher after C&S Wholesale Grocers agreed to acquire the wholesale grocer for $1.77 billion.
What’s down
Tough first day at work: Stellantis sank 0.48% on the day that new CEO Antonio Filosa took the helm at the struggling automaker.
NovoNordisk lost 5.49% after the pharma giant announced disappointing trial results for its newest weight-loss drug.
Super Micro Computer fell 9.77% on the news that it will raise money by offering $2 billion in convertible senior notes.
Wolfspeed plummeted 31.85% after the chipmaker said it plans to file for bankruptcy.
Although many academics argue that value stocks outperform growth stocks, the returns for individuals investing through mutual funds demonstrate a near match.
Introduction
A 2005 study Do Investors Capture the Value Premium? written by Todd Houge at The University of Iowa and Tim Loughran at The University of Notre Dame found that large company mutual funds in both the value and growth styles returned just over 11 percent for the period of 1975 to 2002. This paper contradicted many studies that demonstrated owning value stocks offers better long-term performance than growth stocks.
The studies, led by Eugene Fama PhD and Kenneth French PhD, established the current consensus that the value style of investing does indeed offer a return premium. There are several theories as to why this has been the case, among the most persuasive being a series of behavioral arguments put forth by leading researchers. The studies suggest that the out performance of value stocks may result from investors’ tendency toward common behavioral traits, including the belief that the future will be similar to the past, overreaction to unexpected events, “herding” behavior which leads at times to overemphasis of a particular style or sector, overconfidence, and aversion to regret. All of these behaviors can cause price anomalies which create buying opportunities for value investors.
Another key ingredient argued for value out performance is lower business appraisals. Value stocks are plainly confined to a P/E range, whereas growth stocks have an upper limit that is infinite. When growth stocks reach a high plateau in regard to P/E ratios, the ensuing returns are generally much lower than the category average over time.
Moreover, growth stocks tend to lose more in bear markets. In the last two major bear markets, growth stocks fared far worse than value. From January 1973 until late 1974, large growth stocks lost 45 percent of their value, while large value stocks lost 26 percent. Similarly, from April 2000 to September 2002, large growth stocks lost 46 percent versus only 27 percent for large value stocks. These losses, academics insist, dramatically reduce the long-term investment returns of growth stocks.
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However, the study by Houge and Loughran reasoned that although a premium may exist, investors have not been able to capture the excess return through mutual funds. The study also maintained that any potential value premium is generated outside the securities held by most mutual funds. Simply put, being growth or value had no material impact on a mutual fund’s performance.
Listed below in the table are the annualized returns and standard deviations for return data from January 1975 through December 2002.
Index Return SD
S&P 500 11.53% 14.88%
Large Growth Funds 11.30% 16.65%
Large Value Funds 11.41% 15.39%
Source: Hough/Loughran Study
The Hough/Loughran study also found that the returns by style also varied over time. From 1965-1983, a period widely known to favor the value style, large value funds averaged a 9.92 percent annual return, compared to 8.73 percent for large growth funds. This performance differential reverses over 1984-2001, as large growth funds generated a 14.1 percent average return compared to 12.9 percent for large value funds. Thus, one style can outperform in any time period.
However, although the long-term returns are nearly identical, large differences between value and growth returns happen over time. This is especially the case over the last ten years as growth and value have had extraordinary return differences – sometimes over 30 percentage points of under performance.
This table indicates the return differential between the value and growth styles since 1992.
YEARLY RETURNS OF GROWTH/VALUE STOCKS
Year
Growth
Value
1992
5.1%
10.5%
1993
1.7%
18.6%
1994
3.1%
-0.6%
1995
38.1%
37.1%
1996
24.0%
22.0%
1997
36.5%
30.6%
1998
42.2%
14.7%
1999
28.2%
3.2%
2000
-22.1%
6.1%
2001
-26.7%
7.1%
2002
-25.2%
-20.5%
2003
28.2%
27.7%
2004
6.3%
16.5%
2005
3.6%
6.1%
2006
10.8%
20.6%
2007
8.8%
1.5%
2008
-38.43%
-36.84%
2009
37.2%
19.69%
2010
16.71%
15.5%
2011
2.64%
0.39%
2012
15.25%
17.50%
Source: Ibbottson.
Between the third quarter of 1994 and the second quarter of 2000, the S&P Growth Index produced annualized total returns of 30 percent, versus only about 18 percent for the S&P Value Index. Since 2000, value has turned the tables and dramatically outperformed growth. Growth has only outperformed value in two of the past eight years. Since the two styles are successful at different times, combining them in one portfolio can create a buffer against dramatic swings, reducing volatility and the subsequent drag on returns.
Assessment
In our analysis, the surest way to maximize the benefits of style investing is to combine growth and value in a single portfolio, and maintain the proportions evenly in a 50/50 split through regular rebalancing. Research from Standard & Poor’s showed that since 1980, a 50/50 portfolio of value and growth stocks beats the market 75 percent of the time.
Conclusion
Due to the fact that both styles have near equal performance and either style can outperform for a significant time period, a medical professional might consider a blending of styles. Rather than attempt to second-guess the market by switching in and out of styles as they roll with the cycle, it might be prudent to maintain an equal balance your investment between the two.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on June 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Markets kicked off Friday trading on a high note thanks to comments from Federal Reserve Governor Christopher Waller that the central bank could lower interest rates as soon as next month.
Commodities: Oil prices tumbled at the open after President Trump pushed back his decision to involve the US in the conflict between Israel and Iran by two weeks.
Trade: Stocks gave up their early gains on reports that Japan has canceled high-level meetings with the US after President Trump told the country to spend more on defense.
Posted on June 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Investors looked past the escalating conflict between Iran and Israel, even as President Trump mulled his options for a US intervention, and stocks rose ahead of today’s Federal Reserve meeting.
Economy: Trump called Jerome Powell “a stupid person” hours before the Fed Chair decided to keep interest rates where they were Stocks fell thanks to the Fed’s prediction that inflation will rise to 3.1% by the end of the year, above previous forecasts of 2.8%.
Commodities: Gold fell just a hair as analysts called the commodity’s top, while platinum climbed to a four-year high.
Posted on June 18, 2025 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.
Stocks: Markets sagged as fighting between Israel and Iran continued, with investors worried about escalation after President Trump called for the “unconditional surrender” of Iran’s Supreme Leader Ali Khamenei. The Wall Street Journal reported that he is considering a potential US strike against Iran.
Commodities: Oil prices popped this morning after Trump warned that Tehran should be evacuated.
Bonds: Yields sank after US retail sales came in much lower than anticipated, raising fears of an economic slowdown.
Correlation measures the relationship between two investments–the higher the correlation, the more likely they are to move in the same direction for a given set of economic or market events. Correlation, in the finance and investment industries, is a statistic that measures the degree to which two securities move in relation to each other. Correlations are used in advanced portfolio management, computed as the correlation coefficient which has a value that must fall between -1.0 and +1.0.
So if two securities are highly positively correlated, they will move in the same direction the vast majority of the time. Negatively correlated investments do the opposite–as one security rises, the other falls, and vice versa. No correlation means there is no relationship between the movement of two securities–the performance of one security has no bearing on the performance of the other.
Correlation is an important concept for portfolio diversification--combining assets with low or negative correlations can improve risk-adjusted performance over time by providing a diversity of payouts under the same financial conditions.
Posted on June 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Israel and Iran exchanged missile strikes for a fourth day, but investors are betting that the conflict will remain at least somewhat contained. Reports that Iran wants to de-escalate the conflict and even restart nuclear talks seemed to underline that idea, and markets rose strongly throughout the afternoon.
Commodities: Gold fell as hopes of a ceasefire between Israel and Iran made investors more bullish, while Iranian oil infrastructure was spared from the attacks, pushing crude prices lower.
Bonds: A $13 billion 20-year bond auction this afternoon yielded strong demand, rounding out a series of solid auctions over the last few days that seemingly point to renewed investor confidence in US fixed income.
Posted on June 17, 2025 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: 2%. That’s the portion of Medicaid expansion enrollees who were either not working or in school due to “lack of interest” in finding a job. (Robert Wood Johnson Foundation)
Quote: “It’s just devastating. So much human toil has gone into this. Just when it looked like we could beat this virus, we’re going to give up.”—Dennis Burton, a Scripps Research Institute immunologist, on how a new HIV vaccine was about to start clinical trials before federal funding cuts (NPR)
Read: A look at HHS Secretary RFK Jr.’s new appointees to the CDC vaccine advisory panel. (Stat)
The wait is finally over: USSteel climbed 5.10% after President Trump signed an executive order approving its takeover by Nippon Steel.
Roku jumped 10.43% after announcing a partnership with Amazon that gives advertisers the ability to reach roughly 80% of American households with connected TVs.
AdvancedMicroDevices rose 8.81% on an upgrade from Piper Sandler analysts, who think the semi stock’s AI business will boom.
EchoStar exploded 49.11% after Trump pushed the FCC to resolve its ongoing spectrum dispute with the satellite company.
Victoria’s Secret rose 2.36% on reports that the struggling retailer has attracted the attention of an activist investor.
SageTherapeutics soared 35.37% on the news that it will be acquired by Supernus Pharmaceuticals in a $795 million deal.
MGMResorts climbed 8.10% after the casino company revealed that its Bet MGM online gambling platform is expected to pull in more revenue than previously thought.
Kering, the parent company of Gucci, Yves Saint Laurent, and other luxury brands, popped 12.37% on the news that it has convinced Renault’s CEO to run the company.
What’s down
Sarepta Therapeutics plunged 42.12% after the pharma company reported a second death of a patient taking its Duchenne muscular dystrophy treatment Elevidys.
Reports that Iran wants to end hostilities pushed oil prices lower this afternoon, hurting shares of energy stocks like APACorp (down 2.43%), DevonEnergy (down 1.45%) and ConocoPhillips (down 2.02%).
here are many ways for a doctor, osteopath, podiatrist or dentist to financially invest. Traditionally, this meant picking individual stocks and bonds. Today, there are many other ways to purchase securities en mass. For example:
MUTUAL FUND: A regulated investment company that manages a portfolio of securities for its shareholders.
Open End Mutual Funds: An investment company that invests money in accordance with specific objectives on behalf of investors. Fund assets expand or contract based on investment performance, new investments and redemptions. Trade at Net Asset Value or the price the fund shares scheduled with the US Securities and Exchange Commission (SEC) trade. NAV can change on a daily basis. Therefore, per-share NAV can, as well.
Closed End Mutual Funds: Older than open end mutual funds and more complex. A CEMF is an investment company that registers shares SEC regulations and is traded in securities markets at prices determined by investments. Shares of closed-end funds can be purchased and sold anytime during stock market hours. CEMF managers don’t need to maintain a cash reserve to redeem or / repurchase shares from investors. This can reduce performance drag that may otherwise be attributable to holding cash. CEMFs may be able to offer higher returns due to the heavier use of leverage [debt]. They are subject to volatility, less liquid than open-end funds, available only through brokers and may sells at a heavily discount or premium to [NAV] determined by subtracting its liabilities from its assets. The fund’s per-share NAV is then obtained by dividing NAV by the number of shares outstanding. .
Sector Mutual Funds: Sector funds are a type of mutual fund or Exchange-Traded Fund (ETF) that invests in a specific sector or industry such as technology, healthcare, energy, finance, consumer goods, or real estate. Sector funds focus on a particular industry, allowing investors to gain targeted exposure to specific market areas. The goal is to outperform the overall market by investing in companies within a specific sector that is expected to perform well. However, they are also more susceptible to market fluctuations and specific sector risks, making them a more specialized and potentially higher-risk investment option.
EXCHANGE TRADED FUNDS: ETFs are a type of fund that owns various kinds of securities, often of one type. For example, a stock ETF holds stocks, while a bond ETF holds bonds. One share of the ETF gives buyers ownership of all the stocks or bonds in the fund. If an ETF held 100 stocks, then those who owned the fund would own a stake – albeit a very tiny one – in each of those 100 stocks.
ETFs are typically passively managed, meaning that the fund usually holds a fixed number of securities based on a specific preset index of investments. These are tax efficient. In contrast, many mutual funds are actively managed, with professional investors trying to select the investments that will rise and fall.
The Standard & Poor’s 500 Index is perhaps the world’s best-known index, and it forms the basis of many ETFs. Other popular indexes include the Dow Jones Industrial Average and the National Association of Securities Dealers Automated Quotations [NASDAQ] Composite Index.
ETFs based on these funds are called Index Funds and just buy and hold whatever is in the index and make no active trading decisions. ETFs trade on a stock exchange during the day, unlike mutual funds that trade only after the market closes. With an ETF you can place a trade whenever the market is open and know exactly the price you’re paying for the fund.
INDEX FUNDS: Index funds mirror the performance of benchmarks like the DJIA. These passive investments are an unimaginative way to invest. Passive index funds tracking market benchmarks accounted for just 21% of the U.S. equity fund market in 2012. By 2024, passive index funds had grown to about half of all U.S. fund assets. This rise of passive funds has come as they often outperform their actively managed peers. According to the widely followed S&P Indices Versus Active (SPIVA) scorecards, about 9 out of 10 actively managed funds didn’t match the returns of the S&P 500 benchmark in the past 15 years.
ASSESSMENT
Investing in individual stocks is psychologically and academically different than investing in the above funds, according to psychiatrist and colleague Ken Shubin-Stein MD, MPH, MS, CFA who is a professor of finance at the Columbia University Graduate School of Business When you buy shares of a company, you are putting all your eggs in one basket. If the company does well, your investment will go up in value. If the company does poorly, your investment will go down. Fund diversification helps reduce this risk.
CONCLUSION
Investing in the above fund types will help mitigate single company security risk.
References:
1. Fenton, Charles, F: Non-Disclosure Agreements and Physician Restrictive Covenants. In, Marcinko, DE and Hetico, HR: Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]. Productivity Press, New York, 2015.
Readings:
1. Marcinko, DE and Hetico, HR; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017
2. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006
4. Shubin-Stein, Kenneth: Unifying the Psychological and Financial Planning Divide [Holistic Life Planning, Behavioral Economics, Trading Addiction and the Art of Money]. Marcinko, DE and Hetico, HR; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
We make second investment portfolio opinions affordable
Approximately 1 million allopathic physicians, 150,000 dentists, 200,000 osteopaths, 15,000 podiatrists and 6 million nurses often find it difficult to get an unbiased and fiduciary second opinion on their retirement or brokerage accounts. By offering second opinions for a flat fee, the monetary barriers that prevented colleagues from receiving a second opinion in the past have been removed.
We make second investment portfolio opinions convenient
Here’s how we work: you book an initial appointment with us, answer a few preliminary questions and email us your portfolio information. We then provide a second opinion. It is then up to you to incorporate or not.
We make second investment portfolio opinions timely
Financial markets, jobs and colleague age change like the weather. It is not always okay to wait a week, year or more, to seek a professional second financial portfolio opinion. You need to receive an opinion now. That’s where we come in. We are standing by, ready to take your email [MarcinkoAdvisors@outlook.com] and schedule a free initial consultation within two or three days, or less.
We make second investment portfolio opinions accurate
Fiduciary and non-sales orientated second opinions have the power to change financial lives in the long term. We’ve seen it happen many times. What characterizes a good second opinion? Three things: the opinion must be individualized to your investment portfolio[s], informed and results-oriented. That’s the informed fiduciary approach we take. We are colleagues and look forward to working with you.
Posted on June 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
A Basic Overview for Emerging Physician and Medical Professional Investors
By Somnath Basu; PhD, MBA
There are three basic considerations in any investment decision.
1] The first is the understanding of the investment objective or why the investment is being made. While this may seem somewhat irrelevant at first – why would you be investing if you do not know what you are doing – combining investment objectives can pose problems down-stream.
For example, if you are saving for your retirement so that you can afford the retirement lifestyle you desire (the investment objective), your saving plan should not include any savings you are making for your children’s education (a separate investment objective). Compounding the two savings streams in one plan can very easily lead to one or both of the plans failing.
2] The second consideration is the time horizon of the investment. As a rough guide, investments that need to mature in the next 5-7 years can be considered as short term, 8-15 years as medium term and the rest as long term.
3] Finally, and probably the most important consideration of all is the importance you attach (priority) to achieving your investment objective; in other words, how safe and secure should your investments be. For example, if you are 70 years old and considering how you should invest your retirement funds so that your expenses are covered say for the next 25 years, you do not want a large margin of error in how your investments turn out; you can ill afford to be broke when you are older and hence you want your investments to be as secure as possible.
On the other hand, if the investment is for a second home or a boat, for example, you may wish to engage in some risk taking which may help in lowering your upfront investment needs. It is very important for any investor to clearly understand how much loss they can bear from any investment decision.
Decision Matrix
It is useful to express the investment framework described above as a simple decision matrix. Using the matrix (shown below) as a decision support system should clarify and simplify most investment decisions.
Understanding where in the matrix your decision falls is a very good first step of your decision. Both these elements (safety and time) will ultimately decide the kinds of financial instruments that will reside in your portfolio. We will examine the structure of each of the 9 possible combinations shown in the matrix. Before doing so, let us start by examining the various investment alternatives (e.g. stocks, bonds, etc.) since they have an implicit connection with the two dimensions portrayed in our matrix.
Stocks
Stocks are the most well known and popular form of financial investments. Stocks may be further segregated between large cap and small cap stocks, where the term “cap” is surrogate for the size of the underlying corporation or firm.
Stocks may represent investments in both domestic and international companies. Within the international category, stocks may represent corporations registered in developed (safer) or emerging (riskier) markets. In terms of our matrix dimensions, stocks are best suited when the decision is of medium or long term. In terms of safety, large cap (both domestic and international) stocks are the safest, while small cap and emerging market stocks are the most risky. The riskier the stock, the greater are the profit possibilities as are the chances of large losses.
Bonds
The second common type of investment are bonds Generally, bonds are much safer than stocks with the exception of a class of bonds known as high yield (or junk) bonds. Bonds are issued by companies, governments (domestic and international) and other agencies such as local governments (municipal bonds or “munis” which are especially desirable for those in high income tax rate categories) and quasi-government agencies such as Federal Home Loan Bank, Student Loan Administration, Agricultural Cooperative Banks, etc (collectively known as “Agency” bonds such as Ginnie/Fannie/Sallie Mae, Freddie Mac, etc.).
Government bonds are the safest, followed by agency and municipal bonds and then by bonds issues by corporations.
Corporate bonds may be safe (which are assigned credit safety ratings such as AAA, AA, BBB, etc.) or risky (junk bonds with ratings such as BB, CCC, CC etc.).
Bonds can be used for all time horizons, their maturities ranging from 3 months to 30 years. Very short term bond and bond like instruments (with maturities of one year or less) are known as money market securities which are generally safer than most other investments.
Alternate Investments
Other types of investments include real estate (long term, risky), commodities (such as energy, basic building materials, precious metals, etc.) which are also risky and which may be used for both short term and long term purposes and provide a good hedge (counter balance) in an inflationary environment, derivatives (options and futures) which are very risky and typically short term in nature. Derivatives are generally suggested for very sophisticated investors and are best left alone otherwise.
Risk Reduction
A very important feature about investments is that when various types of investments are bundled together in a portfolio, they help to reduce the risk of the investment decision without affecting the profits in a comparable way. This basic aspect of mixing various kinds of investments (stocks, bonds, etc) to reduce risk is known as diversification and it is a “must” for any investment portfolio. It is a “must” because this technique of risk reduction is generally costless (unless you are paying a financial advisor to do this for you) and it is very worthwhile. All other methods of risk reduction have cost implications.
Scenario Matrix
Armed with this nomenclature regarding various investment types we can now go about examining what the 9 combination (Scenario) portfolios may look like for investment purposes.
Starting with Scenario 1, if you wish to make a short term decision that is very important to you and needs to be very safe, investments should be made in very short term bonds (government or treasury bills)and other similar money market (short term, safe) securities. International short term bonds of developed countries may also be included. Such investment products are generally available through mutual funds or Exchange Traded Funds (or ETFs). ETFs are just like mutual funds except that they are usually cheaper, much easier to buy and sell and may provide tax deferral benefits.
If your investment falls in the Scenario 2 category, include agency/municipal bonds as well as some domestic and international (developed country) large cap stocks while for Scenario 3, smaller portions of small cap and emerging market stocks may be added proportionately while reducing some of the safer investments.
If your investment was a Scenario 4 type of investment, corporate large cap stocks (both domestic and international) could be added to agency or corporate (domestic and international) bonds. Before investing in stocks (in any Scenario) for this Scenario 4, a good question to ask is the following: how profitable were stock investments in the last 3-5 years? If the answer is “very profitable” then reduce the proportion of stocks as compared to bonds in the portfolio. If the last few years were not good, then it would be good to increase their comparable shares. The main reason for this “fine tuning” is that the fortunes of stocks (and many other types of investments) follow a cyclical pattern and the cycle is related to the general cycle of economic (GDP) growth and contraction.
It can be seen now how Scenarios 5 and 6 (as also 8 and 9) will follow a similar pattern as before, increasing proportionally in stocks (of all sizes, domestic/international), real estate, commodities, etc. Portfolios falling in these groups may also include some small cap and emerging market stocks as well as high yield or junk bonds. The proportion of these riskier investments would of course be higher for Scenario 6 over Scenario 5 (and Scenario 9 over 8).
For Scenario 7, the investment portfolio would typically resemble one that would be like an opposite of the portfolio in Scenario 1 and would include a greater proportion of large cap (domestic/international) stocks and a much smaller proportion of bonds. As we move towards Scenarios 8 and 9, the portfolios would be dominated by small cap and emerging market stocks as well as junk bonds.
Assessment
In the discussion above, I have tried to generalize the investment decision in a simplifying way. While the discussion may have centered more on stocks and bonds, it is important to note that all portfolios must “diversify” the investment risks by expanding upon the various types of investment products contained in the portfolios. The very fact that a portfolio contains various types of investments will ensure that the portfolio will perform better than those which are not as well diversified. This will be so in spite of any one of the investment types underperforming at any point in time and the diversification benefit will be received consistently over long periods of time. A popular analogy to this diversification benefit is the common phrase of not putting all eggs in one basket.
Editor’s Note: Somnath Basu PhD is program director of the California Institute of Finance in the School of Business at California Lutheran University where he’s also a professor of finance. He can be reached at (805) 493 3980 or basu@callutheran.edu
Conclusion
The above approach to investment decision-making can be considered as a basic template that can be used universally. For those seeking greater sophistication and who have a foundation built on the above model, expert advice is strongly recommended.
And so, your thoughts and comments on this ME-P are appreciated. Financial advisors please chime in on the debate? Is Basu correct; why or why not? Review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.
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Bonds: The 10-year yield fell after CPI came in lower than analysts expected. The Treasury Department’s auction of 10-year bonds also went well, with strong participation from traders a key sign of demand for fixed income. Zero Coupon: https://medicalexecutivepost.com/2024/11/12/bonds-zero-coupon/
FIVE INVESTING MISTAKES OF DOCTORS; PLUS 1 VITAL TIP
As a former US Securities and Exchange Commission [SEC] Registered Investment Advisor [RIA] and business school professor of economics and finance, I’ve seen many mistakes that doctors must be aware of, and most importantly, avoid. So, here are the top 5 investing mistakes along with suggested guideline solutions.
Mistake 1: Failing to Diversify Investment but Beware Di-Worsification
A single investment may become a large portion of your portfolio as a result of solid returns lulling you into a false sense of security. The Magnificent Seven stocks are a current example:
Apple, up +5,064%% since 1/18/2008
Amazon, up +30,328% since 9/6/2002
Alphabet, up +1,200% since 7/20/2012
Tesla, up +21,713% since 11/16/2012
Meta, up +684% since 2/20/2015
Microsoft, up +22% since 12/21/2023
Nvidia, up +80,797% since 4/15/2005
Guideline: The Magnificent Seven [7] has grown from 9% of the S&P 500 at the end of 2013 to 31% at the end of 2024! That means even if you don’t own them, you’re still very exposed if you have an Index Fund [IF] or Exchange Traded Fund [ETF] that tracks the market. Accordingly, diversification is the only free lunch in investing which can reduce portfolio risk. But, remember the Wall Street insider aphorism that states: “Di-Versification Means Always Having to Say Your Sorry.”
The term “Di-Worsification” was coined by legendary investor Peter Lynch in his book, One Up On Wall Street to refer to over-diversifying an investment portfolio in such a way that it reduces your overall risk-return characteristics. In other words, the potential return rises with an increase in risk and invested money can render higher profits only if willing to accept a higher possibility of losses [1].
A podiatrist can easily fall into the trap of chasing securities or mutual funds showing the highest return. It is almost an article of faith that they should only purchase mutual funds sporting the best recent performance. But in fact, it may actually pay to shun mutual funds with strong recent performance. Unfortunately, many struggle to appreciate the benefits of their investment strategy because in jaunty markets, people tend to run after strong performance and purchase last year’s winners.
Similarly, in a market downturn, investors tend to move to lower-risk investment options, which can lead to missed opportunities during subsequent market recoveries. The extent of underperformance by individual investors has often been the most awful during bear markets. Academic studies have consistently shown that the returns achieved by the typical stock or bond fund investors have lagged substantially.
Guideline: Understand chasing performance does not work.Continually monitor your investments and don’t feel the need to invest in the hottest fund or asset category. In fact, it is much better to increase investments in poor performing categories (i.e. buy low). Also keep in remind rebalancing of assets each year is key. If stocks perform poorly and bonds do exceptionally well, then rebalance at the end of the year. In following this strategy, this will force a doctor into buying low and selling high each year.
Often doctors make their investment decisions under the belief that stocks will consistently give them solid double-digit returns. But the stock markets go through extended long-term cycles.
In examining stock market history, there have been 6 secular bull markets (market goes up for an extended period) and 5 secular bear markets (market goes down) since 1900. There have been five distinct secular bull markets in the past 100+ years. Each bull market lasted for an extended period and rewarded investors.
For example, if an investor had started investing in stocks either at the top of the markets in 1966 or 2000, future stock market returns would have been exceptionally below average for the proceeding decade. On the other hand, those investors fortunate enough to start building wealth in 1982 would have enjoyed a near two-decade period of well above average stock market returns. They key element to remember is that future historical returns in stocks are not guaranteed. If stock market returns are poor, one must consider that he or she will have to accept lower projected returns and ultimately save more money to make up for the shortfall. For example,
The May 6th, 2010, flash crash, also known as the crash of 2:45, was a United States trillion-dollar stock market plunge which started at 2:32 pm EST and lasted for approximately 36 minutes.
And, investors who have embraced the “buy the dip” strategy in 2025 have been handsomely rewarded, with the S&P 500 delivering its strongest post-pull back returns in over three decades.
According to research from Bespoke Investment Group, the S&P 500 has gained an average of 0.36% in the trading session following a down day so far in 2025. The only year with a comparable performance was 2020, which saw a 0.32% average post-dip gain [2].
The most recent example came on May 27, 2025 when the S&P 500 surged more than 2% after falling 0.7% in the final session before the holiday weekend. The rally was sparked by President Trump’s decision to scale back huge previously threatened tariffs on EU —a recurring catalyst behind many of 2025’s rebound.
Guideline: Beware of projecting forward historical returns. Doctors should realize that the stock markets are inherently volatile and that, while it is easy to rely on past historical averages, there are long periods of time where returns and risk deviate meaningfully from historical averages.
Some doctors believe they are “smarter than the market” and can time when to jump in and buy stocks or sell everything and go to cash. Wouldn’t it be nice to have the clairvoyance to be out of stocks on the market’s worst days and in on the best days?
Using the S&P 500 Index, our agile imaginary doctor-investor managed to steer clear of the worst market day each year from January 1st, 1992 to March 31st, 2012. The outcome: s/he compiled a 12.42% annualized return (including reinvestment of dividends and capital gains) during the 20+ years, sufficient to compound a $10,000 investment into $107,100.
But what about another unfortunate doctor-investor that had the mistiming to be out of the market on the best day of each year. This ill-fated investor’s portfolio returned only 4.31% annualized from January 1992 – March 2012, increasing the $10,000 portfolio value to just $23,500 during the 20 years. The design of timing markets may sound easy, but for most all investors it is a losing strategy.
More contemporaneously on December 18th 2024, the DJIA plummeted 2.5%, while the S&P 500 declined 3% and the NASDAQ tumbled 3.5%
Guideline: If it looks too good to be true, it probably is. While jumping into the market at its low and selling right at the high is appealing in theory, we should recognize the difficulties and potential opportunity and trading costs associated with trying to time the stock market in practice. In general, colleagues are be best served by matching their investment with their time horizon and looking past the peaks / valleys along the way.
Mistake 5: Failing to Recognize the Impact of Fees and Expenses
A free dinner seminar or a polished stock-broker sales pitch may hide the total underlying costs of an investment. So, fees absolutely matter.
The first costing step is determining what the fees actually are. In a mutual fund, these costs are found in the company’s obligatory “Fund Facts”. This manuscript clearly outlines all the fees paid–including up front fees (commissions and loads), deferred sales charges and any switching fees. Fund management expense ratios are also part of the overall cost. Trading costs within the fund can also impact performance.
Here is a list of the traditional mutual fund fees:
Front End Load: The commission charged to purchase a fund through a stock broker or financial advisor. The commission reduces the amount you have available to invest. Thus, if you start with $100,000 to invest, and the advisor charges up to an 8 percent front end load, you end up actually investing $92,000.
Deferred Sales Charge (DSC) or Back End Load: Imposed if you sell your position in the mutual fund within a pre-specified period of time (normally one – five years). It is initiated at a higher start percentage (i.e. as high as 10 percent) and declines over a specific period of time.
Operating Fees: Costs of the mutual fund including the management fee rewarded to the manager for investment services. It also includes legal, custodial, auditing and marketing fees.
Annual Administration Fee: Many mutual fund companies also charge a fee just for administering the account – usually under $100-150 per year.
Guideline: Know and understand all fees.
For example: A 1 percent disparity in fees may not seem like much but it makes a considerable impact over a long time period.
Consider a $100,000 portfolio that earns 8 percent before fees, grows to $320,714 after 20 years if the investor pays a 2 percent operating fee. In comparison, if s/he opted for a fund that charged a more reasonable 1 percent fee, after 20 years, the portfolio grows to be $386,968 – a divergence of over $66,000!
This is the value of passive or index investing. In the case of an index fund, fees are generally under 0.5 percent, thus offering even more savings over a long period of time.
One Vital Tip: Investing Time is on Your Side
Despite thousands of TV shows, podcasts, textbooks, opinions and university studies on investing, it really only has three simple components. Amount invested, rate of return and time. By far, the most important item is time! For example:
Nvidia: if you invested $1,000 in 2009, you’d have $338,103 today.
Apple: if you invested $1,000 in 2008, you’d have $48,005 today.
Netflix: if you invested $1,000 in 2004, you’d have $495,679 today.
Unfortunately, this list of investing mistakes is still being made by many doctors. Fortunately, by recognizing and acting to mitigate them, your results may be more financially fruitful and mentally quieting.
REFERENCES:
1. Lynch, Peter: One Up on Wall Street [How to Use What You Already Know to Make Money in the Market]: Simon and Shuster (2nd edition) New York, 2000.
1. Marcinko, DE; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017.
2. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, New York, 2006.
3. Marcinko, DE; Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] CRC Press, New York, 2015.
BIO: As a former university Professor and Endowed Department Chair in Austrian Economics, Finance and Entrepreneurship, the author was a NYSE Registered Investment Advisor and Certified Financial Planner for a decade. Later, he was a private equity and wealth manager
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR-http://www.MarcinkoAssociates.com
Posted on June 11, 2025 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.
Tesla climbed another 5.67% on signs that Elon Musk and President Trump are mending fences and on hype around the robotaxi reveal this week.
TSMC rose 2.63% after the semiconductor company reported that its revenue in the month of May rose 39.6% year over year.
Disney rose 2.65% higher a day after agreeing to purchase Comcast’s stake in streaming service Hulu for $438.7 million. Comcast climbed 2.95%.
Solar stocks got a bit of hope after the Wall Street Journal reported that tech companies are lobbying Congress to keep clean energy subsidies in the tax and spending bill. SolarEdge rose 11.81%, and Sunrun gained 7.13%.
Insmed exploded 28.65% thanks to strong results for the biopharma company’s new treatment for pulmonary arterial hypertension.
Casey’s General Store rose 11.59% after the retailer crushed Wall Street’s profit expectations last quarter and raised its dividend.
McDonald’s lost 1.43% thanks to a double downgrade from Redburn Atlantic analysts, who think the fast food titan’s slowing foot traffic and headwinds from obesity drugs will hurt its growth. That’s the company’s third downgrade in three days.
Stocks: Markets meandered higher as investors awaited news from ongoing US & China trade negotiations in London. Commerce Secretary Howard Lutnick said talks were going well and could continue into tomorrow.
Commodities: Oil soared to its highest price since April on hopes that a trade deal between the world’s largest economies could spur demand, but plunged back to earth after the US said oil output will fall next year.
Crypto: After just barely holding on last week, Bitcoin has now stayed above $100,000 for 30 days straight for the first time ever—a signal to traders that there’s a new level of support for the crypto king.
Posted on June 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Equities inched higher on a handful of optimistic headlines. First, the US and China trade teams met in London today with hopes the two superpowers could resolve disputes over export curbs. Also, a new survey from the New York Fed found that consumer expectations for inflation eased across all time horizons in May. STOCKS: https://medicalexecutivepost.com/2025/04/18/stocks-basic-definitions/
Many doctors are surprised to learn of an alternative investment known as a hedge fund, pooled investment vehicle or private investment fund. Unlike mutual funds, they can be structured in many ways. However, these funds cannot be marketed or advertised, but they are far from illegal or illicit.
In fact, physicians were among the early investors in one the most successful hedge funds. Warren Buffett got his start in 1957 running the Buffett Partnership, a hedge fund not open to the public. His first appearance as a money manager was before a group of physicians in Omaha, Nebraska. Eleven decided to invest some money with him. A few then followed into Berkshire Hathaway Inc, now among the most highly valued companies in the world.
And, more recently, Scion Asset Management® LLC, is a private investment firm founded and led by my eloquent colleague Michael J. Burry, MD and featured in the movie, The Big Short. Other hedge fund mangers of note include: George Soros, Carl Icahn, Ken Griffin, David Tepper, John Paulson and Bill Ackman.
A hedge fund is a limited partnership of private investors whose money is managed by professional fund managers who use a wide range of strategies; including leveraging [debt] or trading of non-traditional assets [real-estate, collectible, commodities, cyrpto-currency, etc] to earn above-average returns. Hedge funds are considered a risky alternative investment and usually require a high minimum investment or net worth. This person is known as an “accredited investor” or “Regulation D” investor by the US Securities Exchange Commission and must have the following attributes:
A net worth, combined with spouse, of over $1 million, not including primary residence
An income of over $200,000 individually, or $300,000 with a spouse, in each of the past two years
The hurdle rate is part of the fund manager’s performance incentive compensation. Also known as a “benchmark,” it is the amount, expressed in percentage points an investor’s capital must appreciate before it becomes subject to a performance incentive fee. Podiatrists should view the hurdle rate as a form of protection or the fee arrangement.
The hurdle rate benchmarks a single year’s performance and may be considered mutually exclusive of any other year, or the hurdle rate may compound each year. The former case is more common. In the latter case, a portfolio manager failing to attain a hurdle rate in the first year will find the effective hurdle rate considerably higher during the second year.
Once a fund manager attains the hurdle rate, the investor’s capital account may be charged a performance incentive fee only on the performance above and beyond the hurdle rate. Alternatively, the account may be charged a performance fee for the entire level of performance, including the performance required to attain the hurdle rate. Other variations on the use of the hurdle rate exist, and are limited only by the contract signed between the fund manager and the investor. The hurdle rate is not generally a negotiating point, however.
Example: A fund charges a performance fee with a 6 percent hurdle rate, calculated in mutually exclusive manner. A podiatrist places $100,000 with the fund. The first year’s performance is 5 percent. The doctor therefore owes no performance fee during the first year because the portfolio manager did not attain the hurdle rate. During year two, the portfolio manager guides the fund to a 7 percent return. Because the hurdle rate is mutually exclusive of any other year, the portfolio manager has attained the 6 percent hurdle rate and is entitled to a performance fee.
High Water Mark
Some hedge funds feature a “high water mark” provision known as a ”loss-carry forward.” As with the hurdle rate, the high water mark is a form of protection. It is an amount equal to the greatest value of an investor’s capital account, adjusted for contributions and withdrawals. The high water mark ensures that the manager charges a performance incentive fee only on the amount of appreciation over and above the high water mark set at the time the performance fee was last charged. The current trend is for newer funds to feature this high water mark, while older, larger funds may not feature it.
Example: A fund charges a 20 percent performance fee with a high water mark but no hurdle rate. A podiatrist contributes $100,000 to the fund. During the first year, the hedge fund manager grows that capital account to $110,000 and charges a 20 percent performance fee, or $2,000. The ending capital account balance and high water mark is therefore $108,000. During year two, the account falls back to $100,000, but the high water mark remains $108,000. During year three, in order for the manager to charge a performance fee, the manager must grow the capital account to a level above $108,000.
Claw Back Provision
Rarely, a hedge fund may provide investors with a “claw back” provision. This term results in a refund to the investor of all or part of a previously charged performance fee if a certain level of performance is not attained in subsequent years. Such refunds in the face of poor or inadequate performance may not be legal in some states or under certain authorities.
ASSESSMENT
Managers of hedge funds, like colleague Dimitri Sogoloff MBA who is the CEO of Horton Point investment-technology firm, often aim to produce returns that are relatively uncorrelated with market indices and are consistent with investors’ desired level of risk.
While hedging may reduce some risks overall, they cannot all be eliminated. According to a report by the Hennessee Group, hedge funds were approximately one-third less volatile between 1993 and 2010.
For a podiatrist who already holds mutual funds and/or individual stocks and bonds, a hedge fund may provide diversification and reduce overall portfolio risk. Consider investing in them with care.
2. Burry, Michael, J: Hedge Funds [Wall Street Personified]. In, Marcinko, DE and Hetico, HR: Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017.
3. Marcinko, DE and Hetico, HR: Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]. Productivity Press, New York, 2015.
4. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Stocks: The S&P 500 touched 6,000 points for the first time since February and wrapped up its fifth positive week in the past seven following a better-than-expected jobs report. The vibes got even better in the afternoon following a President Trump announcement that the US and China trade teams will meet in London on Monday. STOCKS: https://medicalexecutivepost.com/2025/04/18/stocks-basic-definitions/
Bonds: Treasury yields ticked up in response to the solid May jobs report, a sign that investors were reducing bets on the scale of rate cuts this year. That’s not what Trump wants to hear: He urged Fed Chair Jerome Powell to slash interest rates by a jumbo-sized full point to pour “rocket fuel” on the economy. REVENUE BONDS: https://medicalexecutivepost.com/2024/12/20/bonds-revenue/
Oil: Oil prices have gone sideways for three straight weeks now, trading within a $4 range around $65/barrel since the middle of May. We’ll let you know when something interesting happens. CRUDE OIL:https://medicalexecutivepost.com/2024/08/14/wti-crude-oil/
Posted on June 5, 2025 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.
HealthEquity jumped 8.96% after the health savings account custodian boosted its fiscal guidance for the year ahead.
What’s down
Tesla tumbled 3.55% on weak sales data from China and Germany.
Apple fell 0.22% thanks to a downgrade from Needham analysts, who think the company’s valuation is way too high.
Wells Fargo lost 0.36% after the Federal Reserve lifted its 2018 cap on the bank’s assets.
What goes up must come down: ConstellationEnergy sank 4.31% after Citigroup downgraded the nuclear power provider, warning it’s not getting its money’s worth with Meta Platforms.
Asana plunged 20.47% after the work management software maker announced fiscal forecasts that came in below Wall Street’s expectations.
Flowserve lost 6.27% and ChartIndustries dropped 9.46% after the two industrial manufacturers agreed to an all-stock merger of equals.
According to wikipedia, the S&P 500 Dividend Aristocrats is a stock market index composed of the companies in the S&P 500 index that have increased their dividends in each of the past 25 consecutive years. It was launched in May 2005.
There are other indexes of dividend aristocrats that vary with respect to market cap and minimum duration of consecutive yearly dividend increases. Components are added when they reach the 25-year threshold and are removed when they fail to increase their dividend during a calendar year or are removed from the S&P 500. However, a study found that the stock performance of companies improves after they are removed from the index The index has been recommended as an alternative to bonds for investors looking to generate income.
To invest in the index, there are several exchange traded funds (ETFs), which seek to replicate the performance of the index.
Posted on May 31, 2025 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.
The median homeprice jumped 1.6% YoY last month and is sitting at $431,931. Meanwhile, mortgage rates for a 30-year fixed loan (the most common) are still hovering just under 7%. The chief economist of the National Association of Realtors said lower mortgage rates are the key to getting buyers to buy homes again.
UltaBeauty is sitting pretty, up 11.78% after the cosmetics retailer crushed earnings expectations and raised its fiscal guidance for the year ahead.
CostcoWholesale rose 3.12% after beating Wall Street’s earnings expectations, though same-store sales did slip a bit.
Zscaler climbed 9.79% on strong earnings for the cybersecurity company, including 23% revenue growth.
Palantir popped 7.73% on a report from the New York Times that the Trump administration has asked the company to help the government compile data on US citizens.
What’s down
Nvidia slipped 2.92% as rhetoric between the US and China over semiconductor import restrictions reignited investor fears.
Gap plunged 20.18% after the retailer revealed that tariffs will cost between $100 and $150 million.
RegeneronPharmaceuticals tumbled 19.01% thanks to mixed results for its new respiratory drug in late stage trials. The medication is made in partnership with Sanofi, which also dropped 5.61%.
DellTechnologies sank 2.08% after missing earnings expectations last quarter, though it did manage to beat on revenue.
PagerDuty, which is in fact a cloud computing company and not a seller of 1990s tech, lost 11.43% after issuing lower second-quarter guidance than Wall Street forecast.
Posted on May 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
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Stock markets are coming off their worst week since April as President Trump’s tariff threats on Europe and Apple revived trade war jitters. The president has since delayed tariff threats on the EU, giving European stocks a boost yesterday, while Wall Street had the day off for Memorial Day.
No such relief appears to be coming for Apple, which has fallen 8% so far this month, and is the only Magnificent Seven member in the red for May, per FactSet.
Most individual physician portfolios are simply a list of stocks. Doctors with such lists usually know the cost of each position and when they acquired it. It is not unusual to find inherited low cost stocks in the account that have been held for many years.
When you inherit securities, a new cost basis is established (the price of the stock on the date of death or six months later—the executor of the estate makes this determination). Even though there would be no capital gain liability if the stock were sold immediately after date of death, most people simply don’t do anything, just hold the stock. Of course taxes should be considered when selling securities but the investment merit should be the overriding factor.
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Doctor and Accountant Opinions
In a personal communication, Mr. L. Eddie Dutton, CPA said, “First make an investment decision and if it fits into the tax plan, so much the better. Doctors often wonder where they will get the money to pay the taxes. I say to get it from the sale of the appreciated stock and cry all the way to the bank with your profit.”
Dr. Ernest Duty MD, a very successful private investor advises “Ask yourself this question: If you had the money instead of the stock, would you buy the stock? If your answer is ‘Yes’ then, hold on to the stock but if you say ‘No, I wouldn’t buy that stock today’ then, sell it” [personal communication].
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: E-MAILCONTACT: MarcinkoAdvisors@outlook.com
A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.
I want to invest with a manager that has the skills to “hedge” a portfolio, but I do not wish to mix my money with other investors as in a hedge fund.
QUESTION:Can I hire hedge fund managers to manage my account separately?
Some hedge fund managers do take the time to recruit and manage separate accounts, with or without the help of referring brokers.
However, before long the administrative burden of managing so many separate accounts can become quite significant. Hence, the minimums for such separate accounts are generally much higher than if one were to invest in the manager’s hedge fund.
The best feature of these separate accounts is that potentially every aspect of the investment account, including fees, is negotiable. Other features include greater transparency and increased liquidity, since separately managed accounts can often be shut down on short notice.
Investors must be aware, however, that for practical purposes the portfolio manager generally will buy and sell the same securities in the separately managed accounts that the portfolio manager buys and sells in the hedge fund, yet the expenses incurred by the investor will likely be higher.
Posted on May 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS [12:09 am, EST]
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Stock Futures are contracts to buy or sell a specific underlying asset at a future date. The underlying asset can be a commodity, a security, or other financial instrument. Futures trading requires the buyer to purchase or the seller to sell the underlying asset at the set price, whatever the market price, at the expiration date.
Stock futures pointed lower on Monday morning as investors weighed fresh warnings on U.S. debt and the potential for President Donald Trump’s trade war to heat up again.
Dow Futures: 42,406.00
Fair Value: 42,752.14
Change: – 330.000.77%
Implied Open: – 346.14
Late Friday night, Moody’s downgraded the U.S. credit rating one notch. This came as Congress tries to extend Trump’s tax cuts and add new ones, which are expected to deepen federal deficits.
The phrase “sell in May and go away” suggests that investors should sell their stocks in May and avoid the market during the summer months, as historical data indicates poorer stock performance during this period.
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It’s Friday morning, so you’re probably clocking out once you’re done reading this ME-P. And who could blame you, after such a wild month of watching your portfolio zig & zag with every headline.
In fact, why not just sell all your stocks and walk away entirely? You’ve got to admit, it’s tempting. After all, markets have completed an incredible round trip since Liberation Day—you could just call it even, start celebrating Cinco de Mayo a bit late, and maybe check your portfolio again sometime around August.
“Sell in May and go away” might sound like appealing advice these days, especially considering that the market usually spends the next six months under-performing: The S&P 500 gains just 1.8% on average from May through October, the worst-performing stretch of the year historically.
These ‘worst six months’ have gained in eight of the last 10 years,” he recently wrote. He continued: “Not to mention the month of May has been higher nine of the past 10 years, so maybe we should call it,
Posted on May 9, 2025 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.
Former Theranos CEO Elizabeth Holmes on Thursday lost her bid to have an appeal of her 2022 fraud conviction reheard. The 9th Circuit U.S. Court of Appeals denied Holmes’ request for a rehearing before the original three-judge panel that upheld her conviction. At the same time, the court said no judge on the circuit court had asked for a vote on whether to have the full court rehear the appeal.
IonQ is one of the rare cases of a company in the quantum computing industry that reported solid financials. Shareholders rewarded it with a 9.27% gain today.
Axon Enterprise got a 14.13% jolt after the Taser maker reported strong earnings growth and upped its revenue guidance for the current quarter.
Crypto stocks had a great day thanks to bitcoin’s breakout (more on that later). MicroStrategy rose 5.58%, Coinbase climbed 5.06%, and Riot Platforms gained 7.65%.
What’s down
Arm Holdings fell 6.18% after the semiconductor manufacturer warned that both earnings and revenue will come in lower than Wall Street expected this year.
Peloton Interactive lost 6.73% thanks to a bigger-than-expected loss last quarter and a 13% decline in revenue.
Cleveland-Cliffs tumbled off a cliff on the news that the steelmaker is fully or partially pausing production at six of its facilities. Shares tumbled 15.78%.
Krispy Kreme crashed 24.71% after the donut chain paused its deal with McDonald’s, scrapped its dividend to save money, and pulled its fiscal guidance.
Fortinet dropped 8.41% after the cybersecurity company beat analyst forecasts but projected lower revenue in the current quarter than initially expected.
Pharma stocks fell across the board on reports that President Trump will slash drug costs with revisions to Medicare pricing. Eli Lilly lost 3.25%, Bristol Myers sank 1.55%, and AbbVie fell 1.33%.
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