Thanksgiving Leftovers from 2011

The annual diet-wrecking day has passed (up to 7,000 calories, I read somewhere), and I have a groaning table of leftovers that I want to share with you. Not the edible kind, but just as tasty in their own way. So here are some low-fat, low-cal ideas to chew on while contemplating improving your exchequer for 2012.

—The American Medical Association recently published a survey showing that the economic downturn — most importantly, but not exclusively — has altered many doctors' retirement plans.
Of the 52% who have changed their plans, one-third now plan to work locums or part time. It's a smart and useful idea, but in my experience, working less time only works well if you decrease the acuity of the patients you are seeing. High-acuity patients require intense activity to keep your chops up. So a quarter are just planning to keep on keeping on, indefinitely.

— The flip side of the economic shake-up is that patients are delaying visits to their physician. About half of the patients in a PricewaterhouseCoopers survey cited saving money. That wryly suggests to me that some prospective patients are in denial about their health and are looking for an excuse to avoid seeing a doctor, and that some other patients with less discretionary money probably do not really need to be seen in the first place. Unfortunately both groups negatively affect their doctor's bottom line, if not their health.

— J.D. Powers & Associates, that authority on all things automotive, says that 73% of all new cars are acquired by middle-aged and older people. In case you haven't checked lately, the used car market has flourished during the downturn and many younger folks are going that route, even if used car prices are up.

Interestingly, the average age of a car on American roads today is 10.9 years — a record — so the car companies are looking to a big year as our rides finally wear out or become too expensive to maintain. There are 248 million vehicles on the road in the U.S. and about a billion worldwide, FYI.

— The median age for widowed women in the U.S. is 59.4, according to the U.S. Census Bureau. That means that half of them are even younger! That is a wake up statistic for all of us, of both genders, to review our wills, insurances, etc.

— Forty-two percent of patients surveyed could not understand simple instructions on a prescription bottle in a study I just saw. People, that is not acceptable, and we have to find a new way to deal with this problem. And while we are at it, how about coming to grips with the one-third of scripts that never even get filled? As I always say, nine times out of 10, if you don't fill it and take it, it won't help.

— “If you worship money, you will always be poor."

— Precious metals' value is in an inverse relationship to interest rates. So when the Fed perceives inflation to be rising in a growth economy, and rates go up, your over-inflated gold and silver ETFs are going to drop like stones. Be careful.

— One interesting lesson that came out of the new biography on the late Steve Jobs is that when he reassumed control of Apple, the first thing that he did was not to innovate but to increase discipline.
"Without discipline there cannot be creative work." And my favorite corollary, "Without a deadline, it is not work."
— We sometimes forget that zero percent interest rates are not real; they are a manipulative construct by the Fed to stimulate economic activity. "Real" interest rates are determined by the demand-supply tug of war in the open market.

— “It is the stingy man who spends the most." That's a version of an old advertisement for replacing oil filters "You can pay me now, or you can pay me (more) later."

— Never chase rumor stocks; you don't know whether you are the first to hear or the last. And there is no legal reason in the world why the average doctor will be anything but last.

— The average national markdown on foreclosed homes is 27% and with mortgage interest rates at a historic low, now would seem to be a good time to buy into the market, if you can qualify. The kicker is that now the lenders won't make it easy to do so, doctor or not.

— Currency is on the way down, if not out. Last year, only 2.5% of all economic activity in the U.S. was in cash, down 50% from the 5% in 1970.

One example is that last year 50% of all taxi fares in New York were paid with plastic. Another is that last year for the first time more $100 bills were printed than $1 bills. Oh, and pennies now cost more than 1 cent each to produce, even though they are made out of zinc, not copper.

— I read that the cost of a turkey dinner this year is up 13% more than last year. No matter what it is, or why, we need to humbly remind ourselves that we are lucky to live in America and to be practicing medicine in the 21st century. We have a very great deal to be thankful for.

I once heard no less a philosopher than the rock guitarist Carlos Santana say that it is impossible to be happy without gratitude. Have a good holiday and thank you for reading.