Month in Review

• Stock and bond markets rallied during March, with broadening of results- large cap value stocks (+5.0%, Russell 1000 Value TR Index), small cap stocks (+3.6%, Russell 2000 TR Index), and international stocks (+3.3%, MSCI ACWI Ex-USA NR Index) finished the month ahead of large cap growth stocks (+1.8%, Russell 1000 Growth TR Index).
• Economic data continues to look strong in the United States. The Federal Reserve also confirmed their forecast of three 0.25% interest rate cuts in 2024.

Time to Look Beyond Cash?

Last month we discussed the difficulty in forecasting changes in interest rates. During March, investors spent the month aligning their outlook with the Federal Reserve’s guidance, which remains some level of interest rate cuts sometime later this year. While the exact timing cannot be known, we do know that historically there have been opportunities to shift out of cash investments near peak interest rates.

Going back to the six previous cycles since 1984, investors have been better off investing in bonds, US stocks or a balanced portfolio compared to staying in cash during the 12-months following the peak level of interest rates. Forecasting the exact time of peak interest rates/rate cuts is fruitless, but for long-term investors there is an opportunity to look beyond cash.

Source: Bloomberg, FactSet, Federal Reserve, Robert Shiller, J.P. Morgan Asset Management. The 60/40 portfolio is 60% invested in S&P 500 Total Return Index and 40% invested in Bloomberg U.S. Aggregate Total Return Index. The S&P 500 total return figure from the 1984 period was calculated using data from Robert Shiller. The analysis references the month in which the month-end 6-month CD rate peaked during previous rate hiking cycles. CD rate data prior to 2013 are sourced from the Federal Reserve, whereas data from 2013 to 2023 are sourced from Bloomberg. CD subsequent 12-month return calculation assumes reinvestment at the prevailing 6-month rate when the initial CD matures.

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Month in Review

• April saw major bond and stock markets decline due to a shifting interest rate outlook, following higher-than-expected inflation data. The S&P 500 had its first 5% or greater drop since October 2023 in April.
• In the equity market – areas with greater sensitivity to high interest rates lagged, such as small cap stocks (-7.04%, Russell 2000 TR Index). Large cap stocks also declined, with value stocks down -4.27% (Russell 1000 Value TR Index) and growth stocks down -4.24% (Russell 1000 Growth TR Index). Emerging market equities bucked the trend and finished in positive territory (+0.45% MSCI Emerging Market NR Index).
• As of April 30^th, investors were no longer pricing a cut to the Fed Fund rate for 2024, leading major bond markets to 2024 lows (-2.53% in April, Bloomberg Barclays Aggregate Bond TR Index).

Looking Beyond Narrow Equity Market Leadership

Large growth companies continue to drive a large portion of the US equity market’s results during the past three and five years – April was no different. The S&P 500 (weighted by the size of the companies in the index) has outperformed the equal-weighted S&P 500 (representing the results of the average company) by an increasingly wide margin over the past 18 to 24 months.

This has been driven by fast-growing technology companies: technology stocks represent roughly 30% of the market-cap weighted S&P 500, compared to 14% weight in the equal-weighted S&P 500. However, it is important to adopt a longer perspective during these unusual periods. Over the past 15- and 20-year periods, as well as since 2003 – the equal weighted S&P 500 index is ahead or in-line with the market cap weighted S&P 500. On a calendar year basis, the equal-weighted S&P 500 has finished ahead 12 out of 21 years through 2023.

Although the market has been very top heavy, with the fast-growing technology companies driving the market, markets are cyclical, and longer-time horizons highlight the balance over time.

As we approach the Thanksgiving holiday, our Dietitian, Sarah Rupp, MS, RD, LDN, shares some considerations around meal time.

We wish you all a bountiful Thanksgiving with family and friends!

• Finishing the day winding down with a glass or bottle of wine before bed
• Keeping an opened container of frosting in the fridge that can be easily (and often) accessed by spoon to satisfy a sweet craving
• A cigar every time you are on the golf course
• Grabbing a bag of candy at the gas station each time you fill up on gas
• Bringing home a bakery treat each time you visit the grocery store
• Sitting down to watch a show with a bag of potato chips
• A beer with the guys or happy hour with the girls most weeknights because it’s cheap, fun and social
• Hitting up your local drive-through after the kid’s sports practice or game, most nights of the week

These are specifically examples of common, every day activities that have been associated with patterns. “When I do this, I also have that”. This is not to be confused with associations that occur occasionally that would be less detrimental towards health. Life’s about balance, right?

But we are what we do consistently, and if unhealthful links and connections are made between activities and poor quality nutritional choices often enough, for example, your body will likely pay the consequences in the long-term.

Consequences of an unbalanced, poor-quality diet can manifest in various ways, such as the following:

• Chronic disease onset like Type 2 Diabetes, heart disease, Alzheimer’s, and/or cancer
• Or, they can imply manifest in the inflammatory state of living overweight or obese, skin issues, weak immune system, cognitive decline, decreased quality of life and increase healthcare costs.

Yikes!

On the flip side, some examples of positive, health-promoting associations could be the following:

• Reading a paperback book before bed each night, phone placed on “do not disturb” and minimal blue light interactions to promote better sleep
• Starting each meal at a restaurant with a side salad before bread or the main course
• Avoiding the candy and bakery aisles of the grocery store because you know they’re triggers for you, and if you don’t buy it, you don’t have access to it
• Upon getting home from work, choosing to walk the dog rather than unleashing him in the fenced in backyard (which would be easier)
• Enjoying evening screen time with a show or movie without the need to snack mindlessly

It’s worth taking the time to personally think about the subtle connections and links between events and activities as it relates to food and beverage, as this could be a blind spot hindering positive progression towards better health.

Recognizing the power of associations is the first step towards positive change. Awareness is key. Be encouraged! You’re always just one choice away from making a healthier decision, and I’m here to support you on the journey.

Here are some tips for getting started:

1. Identify. What is really frustrating you about your daily or weekly routine? Frustration is a driver to change. Be specific here. If you just focused on what was frustrating and what would make it less frustrating/better, what would it be?

2. Reserve. Pick a time in your schedule and dedicate yourself to education (self-education through reading, watching how-to videos, podcasts, in person professional help), as you prepare to make a change.

3. Clarify. Write down a clear goal and put it somewhere you can see it daily, as a reminder to yourself.

4. Take Action. Go and do it! It’s time to execute rather than thinking about it anymore!

5. Practice this for small habit changes or big habit changes. Enlist accountability people as desired. Pat yourself on the back for taking a step of action.

My goals may differ from yours, and in fact, they likely do, spanning personal to professional aspirations. However, the implementation of self-discipline to commit to change and adapt to new ways of living will likely positively impact all areas of your life.

“If you talk about it, it’s a dream, if you envision it, it’s possible, but if you schedule it, it’s real”. Let’s have less talk, more scheduled action and a space created for ourselves to actually adopt behavior change. Cheering you on today!

Nearly 1 in 5 people living in the United States will suffer a disability lasting more than one year before the age of 65.¹

Many individuals do not like to think or talk about a potential long-term disability, but they do need to talk about disability insurance. 

Why Physicians Should Consider Disability Insurance

Imagine not being able to practice your specialized medical skills due to illness or injury. The financial impact could be devastating for you and your family. As a physician, your income hinges on your ability to work. That’s why individual disability insurance as part of your financial plan is crucial for safeguarding your earning potential.

Understanding Disability Insurance Types

Choosing disability insurance involves understanding the different types and the benefits each brings. For example, there are two categories of disability policies, short-term disability and long-term disability. Short-term disability policies are typically obtained as a group policy benefit from one’s employer while long-term disability policies are also offered as a benefit through an employer BUT are more commonly purchased as an individual policy through a broker or financial advisor.

Additionally, you can purchase own-occupation coverage or any-occupation coverage. The difference between the two is meaningful. Under an own-occupation policy, a person is typically considered disabled if they are unable to perform the material and substantial duties of the job they were working at the time they became disabled. Under an any-occupation policy, a person is considered disabled if they are not able to perform substantial duties of any job for which the person may earn a certain percentage of their pre-disability earnings.  

For physicians, it is essential to work with an advisor who understands your needs and unique situation to recommend the right disability insurance strategy.

Key Considerations

Beyond basic understanding of disability insurance, it’s important to understand key factors like the carrier, benefit amount, elimination period, and renewal options.

• Insurance Carrier – know who you are working with. Currently, only 5 carriers offer “true” own-occupation coverage.
• Benefit Amount – the IRS publishesd “Issue & Participation” amounts based on your income and existing disability coverage.
• Waiting Period – the amount of time one must wait to collect benefits when disabled – typically 90, 180, 365, or 730 days.
• Benefit Period – how long one will be eligible to receive their tax-free benefit. This is typically to age 65, 67, 70, or lifetime.

The above list is not all encompassing but should be considered as you construct your insurance package.

Here to Help

At Confluence Financial Partners, we work with physicians to secure and protect their income in the event an unexpected illness or injury becomes reality. Please reach out if you would like to start the conversation today.

Life and disability insurance and life insurance with long-term care benefits are not issued through Confluence Insurance Services. Products and services referenced are offered and sold only by appropriately appointed and licensed entities and financial advisors and professionals. Not all products and services are available in all states. 

1. Centers for Disease Control and Prevention. Disability and Health Data System (DHDS) [Internet]. [updated 2023 May; cited 2023 May 15]. Available from: http://dhds.cdc.gov
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