financial situation

[militarymd]

Advertisement - Members don't see this ad

How's everyone's Private practice gigs going in light of the ongoing financial crisis?

I know the plastic guys are worrying.

I suspect a lot of elective surgeries will be on hold for a while because people don't want to make their co-pays.

Anyone notice a drop in volume?

 

[jetproppilot]

How's everyone's Private practice gigs going in light of the ongoing financial crisis?

I know the plastic guys are worrying.

I suspect a lot of elective surgeries will be on hold for a while because people don't want to make their co-pays.

Anyone notice a drop in volume?

No drop in volume.

Just a decimating drop in the retirement accounts.😡

I feel for the dudes nearing "retirement".

 

[militarymd]

No drop in volume.

Just a decimating drop in the retirement accounts.😡

I feel for the dudes nearing "retirement".

'
ditto on that.

I've been "investing" in cash over the last 3 years....while my financial advisors have been giving me crap about it for the same 3 years.

They're not giving me crap anymore....they've switched to bugging me to give them the money to invest.

Although it IS a great time to invest, I'm thinking that I might want to take my business elsewhere in light of the fact that these so called advisors would have made a portfolio for me that would have dropped double digit percents....when I managed a single digit fall by keeping so much cash.

 

[Consigliere]

Salaried, so no drop in income. Volume steady.

No complaints thus far. My 401k.......now that's another story.

 

[UTSouthwestern]

Our business has gone UP. I'm usually too tired to post anything.

 

[Planktonmd]

No change in volume yet.

 

[Coastie]

Saw a news story on CNBC last week which claimed higher revenues for derm and plastics guys because people need "pick me ups".

Looks like those guys never lose!

How's everyone's Private practice gigs going in light of the ongoing financial crisis?

I know the plastic guys are worrying.

I suspect a lot of elective surgeries will be on hold for a while because people don't want to make their co-pays.

Anyone notice a drop in volume?

 

[deleted126335]

.

 

[radslooking]

'
ditto on that.

I've been "investing" in cash over the last 3 years....while my financial advisors have been giving me crap about it for the same 3 years.

They're not giving me crap anymore....they've switched to bugging me to give them the money to invest.

Although it IS a great time to invest, I'm thinking that I might want to take my business elsewhere in light of the fact that these so called advisors would have made a portfolio for me that would have dropped double digit percents....when I managed a single digit fall by keeping so much cash.

i think you and I both know that most financial advisors are crap. Sounds like you already have educated yourself. What is your need for them anyway?

And yes, I'm not a gas man, but there's been a definite drop in volume of elective surgeries at my place. Not sure if that's a fleeting, insignificant phenomenon, or evidence of a larger trend.

 

[militarymd]

i think you and I both know that most financial advisors are crap. Sounds like you already have educated yourself. What is your need for them anyway?

And yes, I'm not a gas man, but there's been a definite drop in volume of elective surgeries at my place. Not sure if that's a fleeting, insignificant phenomenon, or evidence of a larger trend.

They do serve their purposes...the details...goldsachs verus proctor & gamble...etc.

 

[maceo]

'
ditto on that.

I've been "investing" in cash over the last 3 years....while my financial advisors have been giving me crap about it for the same 3 years.

They're not giving me crap anymore....they've switched to bugging me to give them the money to invest.

Although it IS a great time to invest, I'm thinking that I might want to take my business elsewhere in light of the fact that these so called advisors would have made a portfolio for me that would have dropped double digit percents....when I managed a single digit fall by keeping so much cash.

i started short selling the market 8 months ago.. no problems here..

 

[militarymd]

i started short selling the market 8 months ago.. no problems here..

YOU are part of the problem if that's what you REALLY did.

All the mother fu ck ers out there who are motivated by greed and fu ck with the market are the cause of all the sh its that's going down right now.

 

[treasurefull2]

YOU are part of the problem if that's what you REALLY did.

All the mother fu ck ers out there who are motivated by greed and fu ck with the market are the cause of all the sh its that's going down right now.

I don't disagree with you, but TECHNICALLY he is NOT breaking the law...

RIGHT?

Everything is this country is based on what's LEGAL vs ILLEGAL, not RIGHT or WRONG...

ANYWAY,

NO need to HIJACK A THREAD....

I WOULD ACTUALLY like to hear from the experiences of practicing physicians....

Carry On 🙂

 

[periopdoc]

We've noticed a drop in volume. We attribute it to a poor demographic area coupled with higher co-pays and deductibles causing people to postpone elective surgery. We are concerned about Jan 1 when insurance coverage typically changes.

I agree, January 1 is when we will start seeing the effect. My PP friends haven't seen a big dropoff yet. I suspect this situation will make the overall job market tighter as quite a few people who planned on retiring this year have begun to have second thoughts.

Overall, my retirement is doing really well. I rolled my 401-K into a mostly self directed IRA when I left the fire department and I also have a "retirement" fund of post-tax income that I play the market with.

I made a killing in Apple. Bought when it was $11 a share and sold at about $100 (multiply that times 4 since there were two 2 for 1 splits intervening).

I missed out on buying Boeing post 9-11. I wanted to buy 2 weeks afterward, but did not have any liquidity to do so.

Thought about buying into Organon (sugammadex). Glad I didn't.

I put a large chunk into Canadian dollars when they were ~75 cents on the USD and sold when they reached parity.

Sold everything and put it into gasoline early this year and sold all that in July.

Currently have everything in Chinese companies except for $5000 I took out and spent on wine just for the hell of it.

Only big money I have lost so far was when I signed over a portion of my IRA to an investment advisor from a major firm. I had to spend money to buy the shares. I lost that and his funds have consistently underperformed the market and the index funds that I selected.

Investment advisors are good for keeping you abreast of what everyone else is doing, but they tend to focus on the short term and have little patience for waiting for a stock to ripen and mature. This is of course because most investors look at things this way and will dump their advisor for failure to gain in the short term.

If you want to play the market, take a weekend to learn about it then research the firms you want to invest in. If you just want to invest, find a no-load index fund, buy it, and forget it. In the long run you will save a lot of money by having no load, and you won't have the tax burden of a fund that is constantly buying and selling.


-pod

 

[periopdoc]

YOU are part of the problem if that's what you REALLY did.

All the mother fu ck ers out there who are motivated by greed and fu ck with the market are the cause of all the sh its that's going down right now.

Oh give my a f uc king break and cry me a river. The market is no more or less a confidence game than Jet's poker table. The stakes are just a little bit higher. Don't like it? Break your money up into 100k increments and invest it in FDIC insured accounts or some other safer investment.

I sure didn't hear you complaining on the upside when investors like maceo drove the market into heretofore unseen heights. We all knew, or should have known, that these heights were unsustainable.

Whining about shorting is like whining about being beat at poker by someone who know all the rules and uses them to their advantage. He bet the market would go down while others (you?) bet it would go up. Don't whine cause you lost the bet.

The people you should be mad at are the ones who tried to tell the average individual that they should be investing in the market. The average person does not belong in the market. However, many average persons have been drawn unwittingly into the market by advisors trumpeting ridiculous gains. Never play the market with anything you can't afford to lose.

-pod

 

[traxtar511]

I don't see anything wrong with shorting stocks. When the market is overvalued how else would you bet on a decline in price?

I do have a problem with short selling and rumors being spread publicly. Additionally, naked shorting that runs a company into operational issues is morally troublesome to me and it amounts to little more than financial warfare.

If you feel the shorts have unjustifiably run the price of a security down, you should be buying. I did this with FFH (a great P&C run by some of the best value investors around...and they bet against the debt of a ton of banks with CDS purchases) and I wish I did it with SHLD (huge short squeeze last month).

(btw...I dont short stocks)

 

[militarymd]

Oh give my a f uc king break and cry me a river. The market is no more or less a confidence game than Jet's poker table. The stakes are just a little bit higher. Don't like it? Break your money up into 100k increments and invest it in FDIC insured accounts or some other safer investment.

I sure didn't hear you complaining on the upside when investors like maceo drove the market into heretofore unseen heights. We all knew, or should have known, that these heights were unsustainable.

Whining about shorting is like whining about being beat at poker by someone who know all the rules and uses them to their advantage. He bet the market would go down while others (you?) bet it would go up. Don't whine cause you lost the bet.

The people you should be mad at are the ones who tried to tell the average individual that they should be investing in the market. The average person does not belong in the market. However, many average persons have been drawn unwittingly into the market by advisors trumpeting ridiculous gains. Never play the market with anything you can't afford to lose.

-pod

to each his own opinion.

 

[sethco]

No drop in volume.

Just a decimating drop in the retirement accounts.😡

I feel for the dudes nearing "retirement".

I feel bad for them, but those dudes nearing retirement should have been going much more conservative (i.e. Much more safe bonds vs. funds) if they were that close to retirement

 

[177983]

I feel bad for them, but those dudes nearing retirement should have been going much more conservative (i.e. Much more safe bonds vs. funds) if they were that close to retirement

Totally agree! If you're ~5 years from retirement, shouldn't most of (if not all of) your investments be in money market accounts and CDs? So far, only 2 MM accounts went negative at all and that was pretty temporary. No one with money in MM accounts should've seen anything close to a double-digit loss.

If you're 5 years out from retirement and you entire portfolio is in stocks, then you're playing russian roulette with your own cash.

 

[jwk]

Totally agree! If you're ~5 years from retirement, shouldn't most of (if not all of) your investments be in money market accounts and CDs? So far, only 2 MM accounts went negative at all and that was pretty temporary. No one with money in MM accounts should've seen anything close to a double-digit loss.

If you're 5 years out from retirement and you entire portfolio is in stocks, then you're playing russian roulette with your own cash.

You forget that many people will be spending 10-20 or even more years in retirement as life expectancies increase. So you're five years from retirement - it's not unreasonable to think that if you're 60 years old and in reasonably good health, you'll still be around another 25 years. That's a long-term outlook in anyone's book.

Granted, it makes sense to shift your percentages from primarily equities to less volatile instruments. But totally abandoning the stock market, unless you have a really big chunk saved up, may not make sense.

 

[Coastie]

The problem is far more complex than that, and in fact, I would say that short selling investors are not the root cause of the problem..not even in the slightest.

YOU are part of the problem if that's what you REALLY did.

All the mother fu ck ers out there who are motivated by greed and fu ck with the market are the cause of all the sh its that's going down right now.

 

[militarymd]

The problem is far more complex than that, and in fact, I would say that short selling investors are not the root cause of the problem..not even in the slightest.

the Root Cause is ......GREED...it is not complex....it is plain and simple GREED.....to get something for nothing.

Rather than INVEST for growth....greedy people go for the short cut.

 

[medicinesux]

[youtube]t_LWQQrpSc4[/youtube]

Duck Tales Inflation Lesson

 

[cfdavid]

'
ditto on that.

I've been "investing" in cash over the last 3 years....while my financial advisors have been giving me crap about it for the same 3 years.

They're not giving me crap anymore....they've switched to bugging me to give them the money to invest.

Although it IS a great time to invest, I'm thinking that I might want to take my business elsewhere in light of the fact that these so called advisors would have made a portfolio for me that would have dropped double digit percents....when I managed a single digit fall by keeping so much cash.

Hey brother, and all my other brothers. Yes, there will be a time to buy, but it's not now. Let the BS settle down. You don't need the ABSOLUTE bottom to capitalize on it. Also, consider the overall fiscal health of the US, and then consider investing elsewhere. I HATE saying this, but it's the future. The U.S. has squandered away so many of it's wealth (we have none) and wealth creating industries, that it's very hard for me to place any real "stock" in the US equities market.

So, when things settle down, consider Asia. I don't have time to track stocks, but you may want to check out Europacific capital, run by Peter Schiff. A very solid dude.

Look it up and let us know your thoughts MIL.

cf david

 

[Jeff05]

what is happening here has been engineered on a scale we can't even imagine. once the smoke clears, there will only a few real winners - the huge banks (like the FED, which is the biggest hoax ever imposed on americans). JP Morgan is making out like a bandit in this one, again...

" I believe that the banking institutions are more dangerous than standing armies...if the american people ever allow private banks to control the issue of currency...the banks and corporations that will grow up around them will deprive the people of their property until their children wake up homeless on the continent their fathers conquered"
THOMAS JEFFERSON 1743-1826

and here's another thought...

"the refusal of King George III to allow the colonies to operate an honest money system, which freed the ordinary man from the clutches of the money manipulators was probably the prime cause of the Revolution"
BENJAMIN FRanklin


so relax. what's going on with the markets isn't your fault. likely, it's not even the government's fault. most of them have too many personal interests or are too stupid to really really act intelligently on your behalf. just know that it WILL get better.

who's comin with me, man? May I recommend AIG and WAMU?

 

[Jeff05]

i don't know about investing elsewhere...my international funds have deteriorated more than domestic ones.

i know it's cliche, but now is the time to invest in America.

 

[traxtar511]

i don't know about investing elsewhere...my international funds have deteriorated more than domestic ones.

i know it's cliche, but now is the time to invest in America.

Agreed. Now is the time to invest for VALUE.

Fairholme Fund is run by some of the best value investors on the planet (Bruce Berkowitz) in case people like funds over finding their own securities. They've done around 17% a year in the past ten years or so.

 

[militarymd]

Hey brother, and all my other brothers. Yes, there will be a time to buy, but it's not now. Let the BS settle down. You don't need the ABSOLUTE bottom to capitalize on it. Also, consider the overall fiscal health of the US, and then consider investing elsewhere. I HATE saying this, but it's the future. The U.S. has squandered away so many of it's wealth (we have none) and wealth creating industries, that it's very hard for me to place any real "stock" in the US equities market.

So, when things settle down, consider Asia. I don't have time to track stocks, but you may want to check out Europacific capital, run by Peter Schiff. A very solid dude.

Look it up and let us know your thoughts MIL.

cf david

one of my advisors told me about him....he (and me) agrees.

 

[Duane E]

the Root Cause is ......GREED...it is not complex....it is plain and simple GREED.....to get something for nothing.

Rather than INVEST for growth....greedy people go for the short cut.

Interesting point. Getting money for nothing means that someone else had to have lost it for it to end up in your hands.

 

[militarymd]

Interesting point. Getting money for nothing means that someone else had to have lost it for it to end up in your hands.

How do you think day traders make money?

Margins?

Shorting?


All the same.

 

[traxtar511]

one of my advisors told me about him....he (and me) agrees.

http://www.youtube.com/watch?v=MoSwkCog-Ro&feature=PlayList&p=02C71D0CDFF9F38B&index=4

in case you are interested, this is peter schiff in 2006 talking about what we are experiencing right now.

 

[TheSandMan]

Nice explanation of the whole wallstreet fiasco. Basically explains our economy and what money is actually backed up by. Its 45min long, but really the first 30min are the most informative

http://www.mymoneyblog.com/archives/2008/09/where-does-money-really-come-from.html#comments

 

[urge]

Not in PP. But, but my hospital might be going belly up if pt census keeps dropping. I wonder what will happen if suddenly they need a loan and are not able to secure it. Will they shut down some wings?

 

[Laurel123]

Volume has not decreased, and in fact it has been quite busy lately. However, our practice has never had very good payor mix. We have a practically nonexistant cosmetic practice and one of our biggest money makers is Ob. And since we are located about 30 minutes from the Mexican border, we have mostly MediCal patients. The economy has not seemed to affect the birthing business at all. And now so many of these Mexican girls are now defying their 'elders' warnings of epidurals causing certain paralysis - we are really busy. It is, though, a bit annoying watching where all my tax dollars go everyday - but it is what it is and we are as busy as ever.

 

[periopdoc]

As a followup question are any of you PP leaders changing your hiring plans in light of the ongoing financial issues? If it were me and I needed one or two new partners, I would probably take a wait and see approach. Work a little extra time, take on a locums etc until all of this shakes out.


-pod

 

[urge]

http://www.nytimes.com/2008/10/15/business/15hospital.html?ref=business

Disappearing Credit Forces Hospitals To Delay Improvements



In late August, even before the credit squeeze reached a full state of crisis, a hospital system in Hawaii filed for bankruptcy reorganization after a lender failed to extend a loan for another month...

 

[radslooking]

I keep getting baraged in emails about downsizing at the hospitals I am at. All three are firing anywhere from 9-40 people.

 

[cfdavid]

'
ditto on that.

I've been "investing" in cash over the last 3 years....while my financial advisors have been giving me crap about it for the same 3 years.

They're not giving me crap anymore....they've switched to bugging me to give them the money to invest.

Although it IS a great time to invest, I'm thinking that I might want to take my business elsewhere in light of the fact that these so called advisors would have made a portfolio for me that would have dropped double digit percents....when I managed a single digit fall by keeping so much cash.

I'd stay in cash/equivalents for a while. Let things settle out. Granted I'm short the S/P 500 and long gold and silver at the moment, so I'm biased.

But, this market is too volatile and we've really just entered the crisis.

 

[cfdavid]

http://www.youtube.com/watch?v=MoSwkCog-Ro&feature=PlayList&p=02C71D0CDFF9F38B&index=4

in case you are interested, this is peter schiff in 2006 talking about what we are experiencing right now.

Dude, Peter Schiff is THE man. Love that dude. You should read Crash Proff if you haven't already.

cf

 

[traxtar511]

Dude, Peter Schiff is THE man. Love that dude. You should read Crash Proff if you haven't already.

cf

I've been following him for the past couple years. I saw him first on CNBC...the few who make sense really stand out haha. Also, I'm a Ron Paul fan, so Schiff gets some points from me there too.

Thanks for the recommendation I'll check it out.

 

[deleted126335]

.

 

[powermd]

Nice explanation of the whole wallstreet fiasco. Basically explains our economy and what money is actually backed up by. Its 45min long, but really the first 30min are the most informative

http://www.mymoneyblog.com/archives/2008/09/where-does-money-really-come-from.html#comments

Absolutely fascinating. I never understood that banks basically "invent" money when they make a loan. I always assumed it was redistributed from somewhere else. The concept of interest and how new money must continually be created in order to pay it back in order to maintain the system is pretty scary.

 

[militarymd]

Volume has not decreased, and in fact it has been quite busy lately. However, our practice has never had very good payor mix. We have a practically nonexistant cosmetic practice and one of our biggest money makers is Ob. And since we are located about 30 minutes from the Mexican border, we have mostly MediCal patients. The economy has not seemed to affect the birthing business at all. And now so many of these Mexican girls are now defying their 'elders' warnings of epidurals causing certain paralysis - we are really busy. It is, though, a bit annoying watching where all my tax dollars go everyday - but it is what it is and we are as busy as ever.

That's the plus of having an almost 100% Medicare/Mediaid practice with NO subsidy from the hospital.

 

[militarymd]

It's all greed. You invest money for one reason: At some point in the future you expect a greater sum to be returned to you. Long/Short no matter. futures/options/commodities no matter. A socially responsible fund or tobacco company, casino, chemical company, nuclear power, porn producer, weapons maker, no matter.

It's all the same.

how about EXCESSIVE greed....I see a difference between wanting a return on INVESTMENT from GROWTH.....and what people have been doing in the last decade.....wanting UNREALISTIC returns.

 

[deleted126335]

.

 

[deleted126335]

.

 

[Mastashake]

how about EXCESSIVE greed....I see a difference between wanting a return on INVESTMENT from GROWTH.....and what people have been doing in the last decade.....wanting UNREALISTIC returns.

I personally don't see making money in a bear market as being excessive. IMO an wise investor doesn't care if the market is going up or down. What they want is predictability. Now granted you're crazy if you're shorting stocks in your 401k, but for the short-term play, there's nothing wrong with going short.

If you don't like the idea of shorting, I understand. Its very blatant in its intentions. But the small guy shorting 100 shares of something isn't a problem. The hedge funds are the guys doing 95% of the shorting.
IMO even the slightest bit of regulations on these entities would solve any sort of issue with that. I'm not saying they SHOULD be regulated, but regulation would help with some of their more immoral practices. But I could be wrong.

🙂

Edited to add: Sorry, I forgot which forum I was in. I know I'm pre-med, and I usually just read the posts in here, and leave this place to you attendings and residents. My bad.

 

[pgg]

Just why is that a plus?😕

Maybe because that payor mix is recession-proof? They're not spending their own money, so they don't decide not to have surgery for financial reasons.

 

[militarymd]

Maybe because that payor mix is recession-proof? They're not spending their own money, so they don't decide not to have surgery for financial reasons.

bingo

 

[radslooking]

I doubt Peter Schiff has done that much better for his clients. He was right in predicting a crisis but he got the crisis wrong. He predicted a cratering of the dollar and hyperinflation with International markets relatively insulated and commodities skyrocketing. Instead International markets have been crushed worse than the US markets, the dollar has strengthened, and commodities have cratered, inflation talk is out the window and people are talking about deflation. Only cash and short term treasuries, have done well while precious metals have been hurt less than most other assets.

You may be right...for now. I don't think the whole story has been written yet.