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Outlook for 2018: Hard Assets: Part I of III
Issue #501, December 18, 2017

More Thoughts on Bitcoin
Issue #500A, December 14, 2017

Fees and Good Relations with Bankers
Issue #500, December 11, 2017

Salvator Mundi
Issue #499A, December 07, 2017

Should You Rent or Own a Home?
Issue #499, December 04, 2017

A Gift Subscription
Issue #Interim Bulletin #498A, December 02, 2017

Stocks vs Real Estate: Asset Allocation: Part II of II
Issue #498, November 27, 2017

When Good Enough is Fine
Issue #497A, November 22, 2017

Stocks vs Real Estate: Asset Allocation. Part I of II
Issue #497, November 20, 2017

The Saudi Arrests and the Perils of Foreign Investing
Issue #496, November 13, 2017

Gambling and Las Vegas
Issue #495, November 06, 2017

Some Tips on Auto Insurance
Issue #494, October 31, 2017

Bitcoin and the Digital (Crypto) Currencies
Issue #493, October 23, 2017

The Coming Bear Market: Part II How to Prepare
Issue #492, October 16, 2017

Some Observations on Cemeteries
Issue #Interim Bulletin #491A, October 12, 2017

The Coming Bear Market: Part I: The Myth of Buy and Hold Forever
Issue #491, October 09, 2017

The Market makes New Highs
Issue #490, October 02, 2017

The Importance of a New High
Issue #489, September 25, 2017

A Little Insurance: Wealth, War and Wisdom
Issue #488, September 18, 2017

Some Observations
Issue #487, September 11, 2017

How to be Successful in Your Career
Issue #486A, September 07, 2017

How NOT to Buy a Home
Issue #486, September 04, 2017

This Week in the Market
Issue #485, August 28, 2017

Is the “Trump Bump” Running Out of Gas?
Issue #484, August 21, 2017

Gold is on the Move
Issue #483, August 14, 2017

The Importance of Estimation
Issue #482, August 07, 2017

Buying Art and Collecting: Part II of II
Issue #481, July 31, 2017

Buying Art and Collecting in General, Part I of II
Issue #480, July 24, 2017

Physicians need to be More Forceful: Follow-up
Issue #479, July 17, 2017

Physicians need to be More Forceful
Issue #478, July 10, 2017

Your First “Real” Investment
Issue #477, July 03, 2017

Leasing a Watch: Don’t
Issue #476, June 26, 2017

The Importance of Your Children having a Job
Issue #475, June 16, 2017

The Problem with Medical Student Debt is—the Med Schools
Issue #474, June 12, 2017

Critters and Varmints in your Home and Yard
Issue #473A, June 07, 2017

Leveraged ETFs
Issue #472, May 29, 2017

Leasing a Vehicle: Don’t!
Issue #471, May 22, 2017

Issue #470, May 15, 2017

More on Buying Jewelry
Issue #469, May 08, 2017

Buying Jewelry: Gold, Diamonds and Pearls
Issue #468, April 30, 2017

Thomas Sowell: Part III of III
Issue #467, April 24, 2017

Thomas Sowell: Pat II of III
Issue #466, April 17, 2017

Live Close to Where You Work
Issue #465, April 10, 2017

Medtronic in Hospital Management
Issue #Interim Bulletin #464A, April 07, 2017

Thomas Sowell: Part I of II
Issue #464, April 03, 2017

A Political Contribution a an Investment: Part II of II
Issue #463, March 27, 2017

A Political Contribution as an Investment: Part I of II
Issue #462, March 20, 2017

Buffett Selling Vacation Home
Issue #461, March 13, 2017

Advanced Placement (AP) ourses
Issue #460, March 06, 2017

The Importance of a Credit History
Issue #459A, March 02, 2017

A Credit Card Scam
Issue #459, February 27, 2017

The Electronic Health Reord
Issue #458, February 20, 2017

Issue #457, February 13, 2017

Platinum and Palladium
Issue #456, February 06, 2017

Economic Outlook for 2017: Part II of II
Issue #455A, February 02, 2017

Economic Outlook for 2017: Part I of II
Issue #455, January 30, 2017

A Story From Vegas
Issue #454A, January 25, 2017

Land Donation Deals and the IRS
Issue #454, January 23, 2017

The Theory of Gambler’s Ruin
Issue #453, January 16, 2017

Student Loans: But Wait, There’s More!
Issue #452, January 13, 2017

A Second Home
Issue #Interim Bulletin #451A, January 04, 2017

The Consumer Confidence Index
Issue #451, January 02, 2017

Social Security
Issue #450, December 26, 2016

My Outlook for 2017: Part II of II
Issue #449, December 19, 2016

My Outlook for 2017: The Market
Issue #448, December 12, 2016

Medicine in 20 Years
Issue #447, December 05, 2016

Higher Interest Rates
Issue #446, November 28, 2016

Trump and the Markets: The Bad and Ugly
Issue #445A, November 23, 2016

Trump and the Markets: The Good
Issue #445, November 21, 2016

Negative Trends: The Suits aren’t Makin’ Steel
Issue #444, November 16, 2016

The New DOJ Fiduciary Rule
Issue #443, November 07, 2016

Barron’s Conference, Part IV of IV
Issue #442, October 31, 2016

Barron’s Conference, Part III of IV
Issue #Interim Bulletin #441A, October 26, 2016

Barron’s Conference, Part II of IV
Issue #441, October 24, 2016

Barron’s Conference, Part I of IV
Issue #440, October 20, 2016

This Newsletter
Issue #439A, October 12, 2016

Memoirs of US Grant: Vol II
Issue #439, October 10, 2016

More Points on Collecting, Investing and the Economy
Issue #Interim Bulletin #438A, October 05, 2016

Personal Memoirs of US Grant
Issue #438, October 03, 2016

Ideas for a High School Part-Time Job
Issue #Interim Bulletin #437A, September 29, 2016

Collecting, Investing, and the Economy
Issue #437, September 26, 2016

Free College
Issue #436A, September 22, 2016

A Military Commitment to Pay for Med School
Issue #436, September 19, 2016

When a CD isn’t a CD
Issue #435, September 12, 2016

I Made a Mistake
Issue #Interim Bulletin #434A, September 07, 2016

What is Your Spare Time Worth?
Issue #434, September 05, 2016

Credit Cards and Bonus/Loyalty Points
Issue #433, August 29, 2016

The Write-off of Student Loans
Issue #Interim Bulletin #432A, August 25, 2016

412 Retirement Plans
Issue #432, August 22, 2016

Join the Club
Issue #Interim Bulletin #431A, August 18, 2016

The Case for Precious Metals and Hard Assets
Issue #431, August 15, 2016

When the US went off the Silver Standard
Issue #430, August 08, 2016

Why NOT to Open a Restaurant
Issue #429, August 01, 2016

Some Tips on Life Insurance
Issue #428, July 25, 2016

More Observations on Negative Interest Rates
Issue #427, July 18, 2016

Issue #426, July 11, 2016

Is a PhD Worth It? Part II of II
Issue #425, July 04, 2016

Is a PhD Worth It? Part I of II
Issue #424, June 27, 2016

Avoid Part-time real Estate Agents
Issue #423, June 20, 2016

Issue #422, June 13, 2016


By Robert M. Doroghazi, M.D., F.A.C.C.

The Importance of Showing Respect

Issue #405, February 15, 2016

    When I was growing up, calling an adult anything besides Mr. or Mrs. or Doctor or Reverend was unheard of. When I was in practice, unless I knew a patient personally, I called them Mr. or Mrs. Even when a patient was younger than my boys, I always showed them respect and called them Mr. or Mrs. Sometimes older patients would say “call me Pearl”. I’d say simply “Mrs. Smith, I just can’t”.
    I always insisted that the ancillary help, from the receptionists in the office to the nurses, X-ray techs and blood drawers in the hospital, call my patients Mr. or Mrs. I have seen some of those people as the years have gone on, and they always say one of the things they remember about me is that I insisted they call my patients Mr. or Mrs.
    It really upset me when someone called my patients by their first name. These patients were never “big shots”, such as a business or civic leader, or the wealthy. It was always the old, the confused, the poor and the minorities. It showed a lack of respect.
    This advice is especially for the young physicians: insist people call you Doctor. You have earned it, you are one of the most respected and honored members of our society, and they will have more respect for you. George C. Marshall is my personal hero. Everyone except his family and closest, oldest friends called him “General”. Roosevelt called Marshall “George” the first time they met, when Marshall had been elevated to Asst. Army Chief of Staff. He did that only once: After that, it was always “General”.
    I think it is essential that your employees address you as Doctor. There must be some separation between the boss and the workers. No matter how good an employee and how long they have been around, over-familiarity will—sooner rather than later—cause problems. It is difficult to discipline or correct someone when they call you by your first name.
    Some languages even have familiar and formal personal pronouns; you—tu (familiar) vs. vous (formal) in French, and Wie geht es Ihnen (How are you? formal) vs. Wie geht es Dir (familiar) in German. 
    I must compliment the bankers. No matter how young you are, no matter how long they have known you, no matter how high they are in the industry, even the president of a large bank, they will always call you doctor. They know how to cultivate people. After all, banking is a business of relationships.
    Several weeks ago I received an email from someone who wanted my business. The salutation was “Hi Bob”. Compare this to when I had the honor as a member of the Awards Committee of the Alumni Board of Governors at the U. of Chicago to notify Dr. Leon Kass, MD ’62, that he had received the prestigious Distinguished Achievement Award. For perspective, Kass received his MD when I was in 5th grade. About midway through the conversation, he said “Dr. Doroghazi, can I call you Robert”? I said “Thank you. Bob is fine”. This is the importance of showing respect.
    If you think I’m just some old fuddy dud, and you’re a cool millennial, consider this practical point. There is absolutely no downside to calling someone Mr. or Mrs. or Doctor, while there is the real potential for offense. When you are seated at a table with a female and they stand up, you stand up. They love it, and other people notice. Manners are no more than showing respect for the other person. You can’t go wrong.   
    We are still nowhere near the market bottom. When the next rally occurs, don’t get drawn in. In fact, use it as an opportunity to lighten up. I’ll discuss the market, and the action in the precious metals, in detail next week.
    It was just reported that Jamie Dimon, CEO of JP Morgan (JPM), bought more than $26M of his company’s stock. The talking heads on TV went ga-ga, saying this is clearly a sign that the financials have bottomed.
    RMD comment: not so fast, partner. There are many reasons an insider might buy, and at the top of the list is a public show of confidence, so don’t be as impressed as you might first think. A sale is different: there is one, and only one reason a person sells stock, and that’s because they think it is going lower. 
    Since the beginning of the financial crisis in 2009, the Fed has returned $600B in “profits” to the Treasury. The Fed bought Treasuries by writing a check—literally, money created from thin air. The Treasury paid the Fed the dividends on these securities, which the Fed then returned to the Treasury.
    RMD comment: This reminds me of a Beavis and Butthead. The kids are to sell candy bars for $1each to raise money for school. Beavis and Butthead sell one. They then proceed to trade that same dollar between each other and eat all of the candy bars. When they show up at school and turn in their $1 to cover all of the candy bars, Butthead adds insult to injury, really piling on, by saying “it’s all there, dude. Count it if you want”.   
    For the last 5 years or so, the top lawyers in NY and other big cities have billed $1,000 per hour for their time. Some top attorneys have now broken the $1,500 per hour barrier.
    RMD comment: I have written a 5-part series on “Negative Secular Trends in Medicine”. “High CEO Salaries” was a Commentary in this month’s American Journal of Medicine. I note that about 10 years ago Wall Street legend Barton Biggs commented that when he began his career in the early 60s the best doctors, lawyers and investment bankers made about the same. He then noted that was no longer the case. My concern is that Medicine is losing its competitiveness for the top kids in the class. Consider if you are a real superstar, who can do whatever you want: you can make 10 times more as a lawyer or 50 times more as an investment banker and finish your training 5 years earlier. 
    I had already decided to write on respect when I watched Turing Pharmaceuticals ex-CEO Martin Shkreli testify before Congress. Shkreli was there because he gained infamy after raising the price of the generic drug Daraprim from $13.50 to $700 per pill. Because he is also under indictment for defrauding investors (see Issue #399, 1/4/16), he refused the answer any questions.
    I hope you didn’t see hearings: Shkreli was arrogant and our Congressional Representatives were embarrassing. After Shkreli left, a long-time Congressman from the Southeast made a point that I think worthy of note. He said (I’m paraphrasing): When he comes up for trial (on the fraud charges), if he acts like that, the jury will do everything they can to convict him. Remember that point if you are involved in a malpractice case that goes to trial, or if you testify as an expert witness.
    Just after the hearings, Shkreli tweeted that the Congressmen were “imbeciles”. (RMD comment: his lawyer needs to take his phone away). After watching the questioning of Fed Chairperson Janet Yellen last week, Shkreli might have a point.   
    This is from a man who started working at Granite City Steel (now US Steel, Granite City Works) in the late 50s.
    “The Mill will shut down temporarily by the end of February, with only a skeleton crew for maintenance. When they reopen—who knows? Having worked there more than 43 years, this seems worse than when they were down 6 months in 2008 (RMD: GC Steel opened in 1868). 
    Obama, through the EPA, is putting so many restrictions on coal companies that he is putting them out of business. Look at Peabody Coal (BTU). Steel companies use a huge amount of coal in the coke ovens and blast furnaces. Next time you are in Granite City look at all of the construction next to the BOF (Basic Oxygen Furnace). Millions and millions of dollars spent just to catch the pollutants, and it will not produce an ounce of steel or improve the quality.
    We tore down the smoke stacks at the old open hearth furnaces (RMD: Gpa Nagy worked there on the stripper crane. The open hearth was replaced by the BOF in the late 60s). The EPA came around and said the smoke stacks needed to be inspected every year (at a cost of $100K). We said they haven’t been used for 50 years and won’t ever be used again. The EPA said they still must be inspected, so US Steel (X) just took them down.
    Bob, this Administration is doing its best to drive manufacturing out of this country. We better get a President in November who understands business and has actually had to make a payroll or our country is in grave danger”.
    RMD comment: Anything else I say would take away from the power of these words from a working man in America. 
    In Issue #391 (11/9/15) I discussed some tips on buying Term Life Insurance when you’re young, when rates are cheap. Someone pointed out to me the added benefits of buying through your place of employment. 1) You get a group discount, which can be very significant. 2) Something that can be make or break: there might be less exclusions. Ex: A) do you scuba dive? B) Do you sky dive? C) Have you flown in more than 1 non-commercial aircraft in the last year? D) Have you missed 3 days or more of work in the last 3 months due to illness?
    If you are in a group practice, the practice will often carry insurance on each individual member, payable to the practice, to fund the buyout should the person die. This is often a chance to piggy-back a personal policy for yourself.

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