Some Timeless Investment Tips

Posted on Posted in Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

It’s tax time again.  Those little pieces of paper that seem so important to the Internal Revenue Service are arriving in our mailboxes.  It’s a good time to review a few basic tips on money management and investing.  You know, the principles no one actually taught us during our many years of training to save lives.

What does money management or investing have to do with health care?  A lot. Financial worries, either personal or institutional, often compromise patient care.  People can act with “impure motives” if dollar signs cloud their thinking.  Everything we recommend to a patient, client, or student should be in his or her best interest.  Those of us in health care should keep our finances in order so that our motives are honorable.  Working with a fiduciary financial planner is similar.  Such a professional is obligated to do what’s best for his client, not himself or his company.

Keeping all of this in mind, there are some timeless investment tips that apply to almost all of us:

  • Saving and investing are different. Step 1 is to get out of debt. Step 2 is building up an emergency fund of at least three to six months of living expenses.  Then investing can begin.
  • Educate yourself and don’t invest in things that you don’t understand. In our culture you can earn an advanced degree and have no idea how to handle money. The first thing you have to invest is time.
  • Sign up for a 401(k) or 503B plan at work and fund it to the max. Investing each month (with money taken out of your paycheck before you see it) is the best path to security.
  • Watch out for management fees and fund expenses. There is a cost to investing, and awareness is key.
  • Take advantage of time and youth. Shocking numbers of people in their 20s, 30s, and 40s have no investments at all.  Modest, steady, monthly investments in your 20s and 30s can lead you to millionaire status in your 60s.
  • Whether you’ve been investing for six months or six decades, do not make decisions based on fear or greed. What separates most people from their money is emotional overreaction when markets tank.  Anyone who has worked in an ER (emergency room), OR (operating room), or ICU (intensive care unit) knows you cannot save a patient if you panic.  “Steady as she goes” sounds simple, but it’s tough when markets correct as they always do.  Stick it out.  The rebound always occurs.
  • Diversify investments and institutions. Depending on your stage in life, some mix of stocks, mutual funds, bonds, REITS (real estate investment trusts), and CDs (certificates of deposit) is prudent. Never put all of your eggs in one basket — or in one hen house.
  • Don’t fall for hot stock tips, free-dinner seminars, or charming financial sales people.
  • Don’t fuss or meddle too much. Some people cannot leave their investments alone. Occasional adjustments are warranted based on your personal situation and market conditions.  A giant oak will never reach its full potential if it’s transplanted every few months.
  • Be cautious and discipline yourself. People with significant financial assets often develop significant egos. Don’t let brokers take advantage of you by flattering your ego.  Remember the Bernie Madoff scandal.  Unscrupulous people can be master manipulators.

Some combination of hard work, discipline, prudence, and common sense helped you develop your career.  Those same principles can help you secure your financial future.

Don’t Do Anything Rash

Posted on Posted in Brain Science, Continuing Education, Psychology, Seminars, Webinars

By Mary  O’Brien, M.D.

Are you feeling upbeat and happy?  Have you looked at your end-of-the-year financial statements and credit card bills?  Most of us are feeling a bit tense and dismayed these days.  But take heart.  The markets have improved since Dec. 31, 2018 and your statements aren’t as bad as they look.

This is actually an excellent time to re-group financially and protect yourself from further chaos.  High frequency trading and complex algorithms contribute to frightening volatility on Wall Street.  A single comment from a government official can trigger 800-point swings on the Don Jones Industrial Average.

However, there are a few prudent principles that still work and may well save your sanity.

  • Get out of debt! This requires a daily commitment, but it’s worked in countless cultures for thousands of years.  Since financial security has a massive impact on health and emotional well-being, learning how to save money and reduce debt are crucial.
  • Don’t spend more than 25% of your monthly income on housing. No one “needs” or “deserves” top-of-the-line everything.  For 40 years, I’ve watched my fellow physicians fall into this trap.  And it is a trap.
  • Don’t even think of buying a house or condo if you can’t put at last 20 percent down. Aim for a 15-year mortgage.  It will not double your payments.  It makes no sense to end up house-poor because you’ve made a bank rich.
  • Stop buying or leasing new cars. Buy a used car or dealer-program car, take care of it, and drive it for 10 to 12 years.  I kept my last car for 22 years.  It was just fine.
  • Don’t be an impulse buyer. We can all live without much of what we have.  Consider the people who lived in Paradise, California, or the panhandle of Florida.
  • Don’t waste money on eating out or ordering restaurant food in until you’re completely debt free.
  • Stop wasting money on fancy coffee drinks and alcohol. Both your wallet and your waistline will benefit from these two steps alone.
  • Never buy anything to impress other people. If your friends are impressed by your Smartphone or your handbag, you need better friends.
  • Stop indulging yourself with excessive spending on hair, nails, facials, massages, etc. Many young women fall into this trap, especially if they pay attention to “beauty influencers” on social media.  You are capable of taking care of your own grooming.
  • Resist the temptation to go on vacations or indulge in entertainment until you have eliminated all debt. Millennials like spending money on “experiences.”  I recommend the experience of being debt-free.

Finally, use the money you save to build up an emergency fund of three to six months of living expenses.  Twelve months are better.  For most people, this should be at least $10,000.  Shocking numbers of people can’t afford to miss a single paycheck — just ask the folks affected by the partial government shutdown.

Next time, we’ll tackle some tips on investing wisely.  Until then, don’t do anything rash.

Not for Party People

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Another year is drawing to an end.  All across the country, folks are stocking up on beer and bubbly for their New Year’s celebrations.  Parties and parades, festivities and football will steal the limelight for a few short days.  But before long, the frivolity will fade and people will settle into their dreary routines.  New Year’s resolutions will be broken as quickly as they were born.  Soon another year will slip silently into oblivion.

All of this can get downright depressing if you really stop to think about it.  I mean — have you ever taken time at New Year’s to evaluate your life?  Are you accomplishing your goals and living your dreams?  Do you even remember what your goals and dreams are?  What wonderful things did you accomplish this year?  Are you a better person than you were 12 months ago?

I take these questions very seriously.  But then, I’m not a party person.  New Year’s has always been my time for taking a personal inventory, a self-assessment of growth and progress.  Having worked with older patients for decades, I’m convinced this exercise is not in vain.  People don’t stay in neutral long.  They either move forward, or they slide into reverse.  But the laws of physics hold fast.  Going in reverse is no problem.  It’s easy and requires no effort.  Going forward requires thrust or energy.  And each one of us must supply our own.

Conducting an annual self-assessment will not appeal to whiners and wimps.  And it’s probably not for party people.  It demands integrity, self-discipline, and drive.  After all, the whole point of this exercise is propelling oneself toward some pretty lofty goals.  Blaming others or the culture for one’s own faults and failures defeats the purpose.

Each of us has different challenges, circumstances, and goals.  My self-assessment questions have served me well over the years.  You may need to amend them, but see if they don’t get you thinking:

  1.  How many books have I read this year?  Did they really sharpen my thinking?
  2.  What are the most important lessons I learned?  Have I put them into practice?
  3.  Did I take good care of my body and health?
  4.  Did I give my family the time and attention it needed?
  5.  Have I learned a new skill or expanded my fund of knowledge?
  6.  Have I further developed a talent I already have?
  7.  Did I devote enough time to my spiritual life?
  8.  Did I try to make life better for others?
  9.  What did I do to invest in my future?
  10.  When I reap what I’ve sown, will I be happy with the results?

This New Year’s review may not be as scintillating as champagne or as fun as football.  But its effects will last a lot longer, and you won’t wind up with a headache!

An Old-Fashioned, Counter-Cultural Approach

Posted on Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Psychology, Seminars

By Mary O’Brien, M.D.

Are you already worn out from holiday activities?  There is Thanksgiving travel, Black Friday, Cyber Monday, and reports of morning, noon, and night sales hitting record levels.  The cold and flu season is well underway, and millions of Americans are totally tuckered out.  They will, nonetheless, try to sustain this frenetic activity for another month.  There is an alternative, old-fashioned, counter-cultural approach.  It’s called Advent.

Long, long ago, before people had electronic devices surgically implanted into the palms of their hands, they observed a quiet, disciplined period of waiting for Christmas.  The word, “Advent,” is from the Latin word “adventus,” referring to the arrival of a significant person, time, or event.  Over the centuries, Christians developed the practice of spending the four weeks before Christmas in prayer, fasting, and giving alms to the poor.  It was a way to discipline themselves, physically and spiritually.

Many of our grandparents were very serious about this tradition.  They waited to put up a tree and decorate it until Christmas Eve.  The 12 days of Christmas were actually celebrated from Christmas Day to January 6th, the Epiphany, or arrival of the three Wisemen.  Today, Christmas-in-July sales have us in major shopping mode for half the year.  Many people are tired of Christmas long before it arrives.  By the time credit card bills arrive in late December, very few people are ready for any sort of Epiphany, spiritual, or otherwise.

There are some healthy, helpful things any of us can do in the spirit of Advent.  Most folks want to find meaning in their lives that extends beyond acquiring money, stuff, and titles.  Nonstop, frantic striving can only distract us for so long.

  • Before the holiday craziness consumes any more of your mental, physical, emotional, or spiritual energy, consider a slightly different approach to December: “Fast” from all electronics for one hour a day (while you’re actually awake).  This will reveal volumes about where you are in life.
  • Practice the old-fashioned discipline of giving up candy, sweets, desserts, etc. The first bite of your favorite holiday treat will taste heavenly.  Chances are good that you’ll drop a few pounds in the process.
  • Avoid spending money on fancy coffee, eating out, alcohol, and other little indulgences; give the money you save to help a family devastated by the recent natural disasters.
  • Do something nice for someone else — anonymously.
  • Do something nice for someone you really can’t stand.
  • Invest 15–25 minutes each day in prayer, meditation, contemplation, or spiritual reading to focus on what matters most to you.
  • Make a serious effort to replace cynicism and sarcasm with gratitude and gentleness.

If all of us did even half of these things for a few weeks, the ripple effect would be immense.  Advent.  It’s an old-fashioned, counter-cultural approach.

A Little Extra Thoughtfulness

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

It’s coming.  The busiest travel time of the year is nearly here.  Thanksgiving is next week, and we’ll be bracing for impact.  Tens of millions of people will go somewhere they don’t really want to go and will do things they don’t really want to do — in some cases with people they may not even like.

Painful delays at airports, agonizing congestion on highways, bad weather, stress, and exhaustion will give a green light to viruses everywhere. Welcome to the cold and flu season.  It might be prudent to rethink a few things.

Despite a strong economy, this has been a very tough year for many people.  Historic flooding, catastrophic hurricanes, terrifying tornadoes, and hellish wildfires have inflicted untold suffering and loss.  Mass shootings, violent threats, angry mobs, and generally vicious behavior have overshadowed civility and decorum.  Many decent people across the country feel overwhelmed and demoralized.  I don’t think anyone needs more stress, certainly not at the Thanksgiving table.

But all is not lost.  Difficult situations bring out the worst in some people but the very best in many others.  Heroic acts of courage and compassion abound whenever disaster strikes.  Few of us will ever have to save someone from a raging flood or fire, but we can all be a bit more thoughtful and understanding.  This year, consider a few ideas that might make Thanksgiving less stressful and more pleasant for everyone:

  • Don’t put pressure on loved ones to travel. People only have so much time, energy, and money to spare.  Controlling relatives is not helpful here.
  • Include someone who might otherwise be alone.  Chances are good such folks are all around you.
  • Don’t be a perfectionist in the kitchen. Thanksgiving is not a competitive event.
  • Offer to help or bring a dish, but don’t force your brussels sprouts casserole on the host. Some people don’t know when to cease and desist.
  • Resist the temptation to talk politics. Now is not the time to upset people.
  • Put a ban on phones, television, and assorted other devices. Through your church, synagogue, or club, sponsor a Thanksgiving dinner for a family in need.
  • Show interest in other people at dinner. Good conversation starts with sincere questions about the other person and really listening to that person.
  • Don’t inflict yourself on others if you’re sick. Someone will almost certainly be happy to bring you some wonderful leftovers.
  • Be genuinely grateful for all the blessings you do have. Let people know that you appreciate them.

Thanksgiving is a lovely holiday with charming traditions.  With a little extra thoughtfulness, we can make it better than ever for everyone.

Calm Down, Slow Down, and Live

Posted on Posted in Brain Science, Continuing Education, Pain, Seminars

By Mary O’Brien, M.D.

I witnessed a four-car accident this week.  Moments before it happened, I knew what was coming.  A driver wanting to turn left raced through a light turning red.

Another driver coming in the opposite direction jumped a light before it turned green. They collided.  Two cars following much too closely plowed into the mess.  Everyone was all right, but a major intersection was blocked and lots of people were ready to explode.

This scenario plays out all over the country every day. Impatient, rude, distracted drivers are increasingly problematic.  Drunk or sleep-deprived drivers cause a tremendous number of accidents, but 66 percent of traffic fatalities are caused by aggressive driving.

Nearly everyone is in a hurry today, even in a place like Myrtle Beach, South Carolina.  I suppose at 9 A.M. many people are still trying to get to work, but a traffic accident will really make you late.

Research has shown that aggressive, angry drivers have distorted depth perception. This is worrisome, since traffic congestion is not about to ease and most people drive much too close to the car ahead.  Add a little rain, fog, snow, or ice, and an accident is inevitable.

Halloween is on October 31, with Thanksgiving and Christmas travel soon to follow.  Since an ounce of prevention really is worth a pound of cure, there are a few tips we can all use to stay safe:

  • Get in touch with reality. Many people underestimate how long it takes to go anywhere.  Stress levels ease when you routinely leave an extra 15-20 minutes to reach your destination — more if you drive in a large city.
  • Leave more space between your car and the one ahead. The laws of physics work whether we like them or not.  Sooner or later someone will have to stop unexpectedly.
  • Don’t try to run a stoplight. At some point, it will not go well for you.
  • Don’t be rude on the road. Cutting off another driver, yelling, making vulgar gestures, or otherwise being aggressive will not help.
  • Stay focused on driving. Unless you’re driving across Wyoming or west Texas, you must have your wits about you at every moment.  Even talking on the phone or sipping coffee can be dangerous.  Texting is flat out foolish.  Don’t do it.
  • Be considerate of other drivers. We’ve all struggled to get in the correct lane on a congested highway.  Unless it’s simply unsafe, let another driver merge ahead of you and never fuss at someone for being gracious to others.

Every person today is dealing with stress, and most of us have made an occasional error on the road.  Perhaps we could all calm down, slow down, and live to enjoy the holidays.

A Circle of Prayer

Posted on Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Psychology, Seminars, Webinars
Credit: National Review

They knelt in prayer and grief.  A dozen brave, dedicated, selfless firefighters and rescue personnel in Wilmington, NC were heartbroken on sight.  A mother and her 8-month old baby girl were killed when a tree crashed through their house during Hurricane Florence.  The father was severely injured and rushed to the hospital.  Upon completion of their agonizing task, the first responders were captured in a photo kneeling in a circle of prayer.  Within hours, the image went viral and millions felt their anguish.

Suffering and heartache are rampant here in the Carolinas now.  It will take many months and even years for people to recover from the devastation.  This part of the country has been my home for many years and my heartfelt thoughts and prayers go out to everyone in need.  I know that everyone at INR joins me in that circle of prayer.  To all our customers and colleagues who have worked with us for so long, we wish you Godspeed in your recovery.

To Whom Much Is Given

Posted on Posted in Brain Science, Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Something is seriously wrong.  The unemployment rate is around 3.9 percent.  The most recent GDP (Gross Domestic Product) figure shows a 4.1 percent gain.  These are tremendous numbers, and yet, millions of people who should be building lives of their own are still clinging to mommy.  They don’t want to grow up, pay their own way, develop a career, make a commitment to another person, begin a family or household of their own, or accept responsibility for anything.  This is not good.  Maturity begins with the acceptance of responsibility.

Unfortunately, many of my fellow baby boomers have indulged their children to the point of pathology.  Feverish efforts to create a perpetual soft landing for kids have only enabled endless dependency.

In World War II, millions of young men in their teens and twenties signed up to defend the country.  No one who had stormed the beaches of Normandy or fought at Guadalcanal came home to sponge off mommy and daddy.

Even the relatively spoiled people of my generation would have chosen to live in their Volkswagens after college rather than go home to live with mom and dad.  Living with your parents after college was considered the ultimate sign of personal failure.

There are of course, millions of millennials working hard to develop their careers and raise young children.  But far too many still think that eternal adolescence is “cute.”  Arrested social development and “infantilization” of adults is not cute.  It’s medically, psychologically, socially, and even spiritually abnormal.  Our culture has gone off the rails attempting to normalize behavior that is clearly dysfunctional and disturbed.

Work is essential for a man to feel good about himself.  A woman needs a sense of accomplishment too, but a woman can also define herself through relationships and caregiving.  Depriving a young man of the satisfaction and fulfillment that comes with physical labor, challenge, and struggle is not in his best interest.  All too often part of the problem is a mother who desperately wants to feel “needed.”  Parents may complain about an adult child who won’t leave the nest, but as long as mom and dad pay the bills, little darling has no motivation to get off the couch.

Sometimes real love is difficult and even disruptive.  The fundamental responsibility of any parent is to provide and protect the child when he or she is young.  The job is not complete, however, until a child has been taught the skills necessary to become a capable, honorable adult who gives more than he or she takes.

“To whom much is given, much will be required.” Some people think that sounds harsh.  Actually, it’s one of the secrets to a happy, fulfilling life.

A Wonderful Ritual

Posted on Posted in Continuing Education, Homestudy, Psychology, Seminars, Webinars

It has started.  Across the country, kids from kindergarten to college are heading back to school.

I miss that back-to-school ritual.  Shopping for new clothes (even uniforms), textbooks, pens, folders, notebooks, and lunch boxes made me happy.  Spending a day with my mom and sister focused on a bright, new beginning.  It was a wonderful ritual.  We would always be excited to show our dad all the new treasures.  He would heartily approve of our purchases and remind us to use them to get good grades.

I could be wrong, but I get the feeling that much of that ritual and tradition is fading away.  Online shopping, frantic last-minute errands, and people doing “their own thing” seems to be replacing planned family outings.  Maintaining some structure, routine, and ritual is more and more challenging.

But the “whatever” approach to life is not very fulfilling.  Human beings, whether they are in a newborn nursery or a nursing home, do best when they have a healthy routine.  If you have school-age kids, it may help to consider a few time-tested principles.  Establishing these “rules” is a lot easier at the start of the school year than it is after a month or two of foundering and fiascos.

  • Preserve and protect bedtime — few factors influence performance at school (or work) more than sleep. And most kids need a lot more of it.  Unfortunately, when kids stay up until 10, 11, or 12 at night during the summer and then try to go sleep at 8:30 or 9, things don’t go well.  Begin to ease everyone into school-day bedtimes and wake-up schedules a week before school starts.  Only the strongest and wisest of parents will even attempt this.
  • Get everyone up early enough to have a decent breakfast and avoid morning rush and chaos. Some people never learn this principle, but most successful people get up long before they “have to.”
  • Teach kids to prepare as much as possible the night before — homework, projects, clothes, permission slips, etc. This is another principle of success in life and does wonders for easing stress and anxiety.
  • Limit TV and screen time, especially on school nights. Bullying and generalized nastiness abound on social media.  Kids will always complain about rules and boundaries, but deep down every child wants to feel safe, secure, and loved.  It helps if mom and dad set a good example here.
  • Create a home environment that’s conducive to calming down. Overstimulation and overextending are epidemic in our culture and disastrous for concentration or restorative sleep.
  • Establish and maintain a family dinner hour without devices. Kids must be taught how to have a conversation and actually be attentive to others.  There are 50-somethings out there who haven’t learned this.

People will always insist they don’t have time for lots of things.  But we all get 24 hours of time each day.  The question is, which activities will really make a difference down the road?  Establishing a healthy back-to-school routine can be the foundation for a happy, successful life.

Pearls of Wisdom

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

He was a disciplined thinker, a real-life Mr. Spock, in a world where so many worship emotion.  Dr. Charles Krauthammer died on June 21, 2018, after a battle with cancer and 46 years of paralysis from a diving accident.  He finished medical school at Harvard and trained as a psychiatrist before turning to political journalism.  Early in his career he won a Pulitzer Prize.  The rest is history.

Dr. Krauthammer was an intellectual force of nature.  Facts, reality, logic, and truth served as his compass.  He had an unusually inquisitive mind and was open-minded enough to allow his thinking to evolve.  This stood in stark contrast to so many in the media who idolize notions and emotions.

Always patient and respectful in debate, Dr. Krauthammer was kind, thoughtful, gracious, and dignified.  But those qualities never suppressed a laser-like wit and genuine sense of fun.  He knew what there was to know about baseball and chess. People loved being around him because they always learned something and had a good laugh.  Being confined to a wheelchair did not prevent him from enjoying life.

Most people will remember Dr. Krauthammer for his political analysis and writing.  But as a physician who struggles with multiple illnesses, I have a slightly different focus.  Here are just a few pearls of wisdom I learned from his remarkable example:

  • Resist the temptation to feel sorry for yourself. Bitterness and victimhood will not solve anything.
  • Think about death every day. This is not morbid.  Charles Krauthammer was a wonderfully cheerful, funny man.  Confronting death allows one to appreciate life fully.
  • Keep your focus on others. We live in an age of malignant narcissism.  Krauthammer rarely talked about himself and kept his focus on the needs, problems, hopes, and dreams of other people.
  • Be courageous enough to say what you think but always be measured and civil. Hatred and nastiness abound today. There’s nothing constructive or healthy about it.  Civility, patience, gentleness, and humility will always be the mark of true wisdom.

Dr. Charles Krauthammer could have given up on everything at the bottom of that swimming pool when he was 22 years old.  He chose to fight back, and I’m one of millions who is grateful that he did.

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