Transcript
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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
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to build their own research program, whether or not they have a mentor.
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As clinicians, we spend a decade or more as trainees learning to take care of patients.
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When we finally start our careers, we want to build research programs, but then we find
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that our years of clinical training did not adequately prepare us to lead our research
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program.
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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
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However, clinicians hold the keys to the greatest research breakthroughs.
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For this reason, the Clinician Researcher podcast exists to give academic clinicians
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the tools to build their own research program, whether or not they have a mentor.
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Now introducing your host, Toyosi Onwuemene.
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Welcome to the Clinician Researcher podcast.
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I'm your host, Toyosi Onwuemene, and it is an absolute pleasure.
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It is an absolute pleasure to be with you today.
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Thank you for tuning in.
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I am excited today because I have an extra special guest.
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Today I am joined by Dr. Stephanie Pearson.
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Stephanie, welcome to the show.
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Hi, thank you for having me.
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Stephanie, I'm so excited that you're here because you are not our traditional guest
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on the show.
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You are here to talk to us about disability insurance.
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So I want you to introduce yourself to my audience and let us know how did this surgeon
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now turn to this, to disability insurance as part of what she does.
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Okay.
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I will give the very abridged story.
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So I am an OBGYN by training, trained and worked in the Philadelphia area for my clinical
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career and unfortunately I was kicked in the shoulder during a difficult patient delivery
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and she just got me in the right spot.
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And I ended up with a torn labrum, developed a frozen shoulder, had surgery, went to sleep
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getting told I'd be back to work in 12 weeks and August there will be 11 years that I am
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away from clinical medicine, not that I'm keeping count or anything.
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And unfortunately I learned a lot the hard way and I thought that I did everything right
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in planning for myself and my family.
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And it was really through sheer ignorance and I don't mean the ignorance that we should
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know something and we don't.
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I mean real pure ignorance, the stuff that we don't know because we don't know it.
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That I felt as though I had not been properly educated or advocated for and really took
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my journey and what happened to my family and became really passionate about the topic
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thinking that I couldn't possibly be the only physician in the position I found myself in.
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And after speaking to a bunch of friends and colleagues, it just seemed like this is where
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my life was supposed to take me.
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I know it sounds a little bit trite that things happen for a reason and maybe it's just what
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keeps me focused.
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I really thought that I would probably die at the OR table in like my 80s and it's just
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not the deck of cards I got dealt.
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So here I am, I started an insurance company and we focus mainly on physicians for disability
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and life insurance.
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I'm truly trying to change the way that this gets taught to young physicians, the way that
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it gets handled and really care about the service aspect.
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I went into medicine to have a service led life and this allows me to continue to do
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that in a little bit of a different space.
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Stephanie, thank you so much for really distilling the story down.
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You've done this a lot because I've heard the longer version and to some extent, I do
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want my audience to just hear a little bit more of that story because it's a really powerful
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story and you clearly are a remarkable person.
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You've been through a remarkable number of things and to turn that around into this mission
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focused career is super awesome.
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But I do want to take a step back to the part in your story where you didn't know this was
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coming.
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You struggled through a lot of going through specialists, going through surgeries and at
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the end of it, you lost your job.
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I want us to necessarily stay positive, but I do want you to speak to the failure of expectation,
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all the things that happened in that moment, especially in that journey that was so unexpected
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and perhaps many physicians feel like, oh, that could never be me, but it could possibly
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be them.
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So going way back to the beginning, after the initial injury happened, my first orthopedist
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quite honestly kind of blew me off.
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He said that professional baseball pitchers pitched with torn labrums, so I should be
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able to do my job.
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And he had some other choice words that I'll keep to myself, but I put my head down and
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I did what I think all type A physicians do, you figure out how to compensate.
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And I figured out how to compensate until I couldn't.
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And it was when I really couldn't compensate anymore that I met the orthopedist who ended
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up doing my surgery.
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And I woke up from surgery with him sitting at the corner of my bed.
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And I kind of knew at that point, nothing against orthopedic surgeries, but most of
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them are so busy that they really don't stick around.
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So I knew the fact that he was there when I woke up was not a great sign.
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And he did say that it looked like a bomb went off in my shoulder and I probably would
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not get back to practice the way that I had previously.
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And to kind of set that up, OB-GYNs wear lots of hats.
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And my biggest hat was as a surgeon.
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I was the person that people sent people to and it was my happy place.
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I mean, I truly, truly loved being in the OR and being able to truly fix and heal people.
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And I did a lot of OB.
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I was originally told that I couldn't operate, I couldn't do obstetrics, but I was actually
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cleared to do office GYN as tolerated.
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And I thought I'd be given that opportunity.
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I had recently been asked to be the chairperson of our department and I love teaching residents.
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I thought, okay, I'm still going to practice, I'll be in a little bit differently.
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And unbeknownst to me, my contract said that I needed to be able to do 100% of my job and
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I no longer could.
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And I got unceremoniously terminated the day that my FM ballet was up and nobody called
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me, like not my office manager, not my senior partners, no one from the hospital.
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And once I got terminated, it turned out that I couldn't get malpractice insurance because
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one of my orthopedic notes says that I'm a liability.
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So it really was in a matter of probably days that I went from thinking I still have a job
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and I can still practice medicine to, oh my God, what am I going to do now?
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And then to pile on top of that, the group disability benefit that we had at our hospital
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in fine print didn't cover work-related injuries.
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So then I got my second blow that I literally got told I would have been better off had
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I fallen off my bike, which is a tough pill to swallow when you're doing your job, right?
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I was doing what I was supposed to do.
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I had a safe baby, I had a safe mom, yet my world kind of came tumbling down.
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So those were the biggest two blows.
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And then the third blow came when I realized that my private policy just wasn't quite what
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I thought it was.
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So going back, I truly thought I did all the right things.
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I had a policy through the work.
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I had a policy on my own.
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And then all of a sudden, it was just not what I thought I had.
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And so it was a lot.
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I was not in a good mental head space.
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But I think like a lot of physicians, I went through the dark spot, came out the other
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end and figured out what I needed to do to keep going.
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Stephanie, thank you so much for just your courage and sharing your story and the challenges
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that you've come through.
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And thank you because you're using it as a platform to help other physicians as well.
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So I feel like this is a great point at which we should stop and talk about what is disability
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insurance?
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And we're going to get into a little bit more of the fine print, but really give us a, I
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think we have a sense of it, but help us understand and especially kind of actually let me stop
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there because you have a lot to tell us.
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No, yeah.
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So at its basic definition, disability insurance is income protection.
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So so many of us growing up, we hear about health insurance, we hear about auto insurance,
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we hear about homeowners insurance or renters insurance.
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People talk about insuring jewelry, right?
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No one ever told me that I needed to insure my ability to make money, which when you think
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about it is our biggest asset.
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And I don't mean that to sound salesy, but it's true, right?
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We sacrifice so much becoming physicians.
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We give up our 20s, some of us part of our 30s, our friends are already making money.
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Not only are we not making a remarkable amount, but we're paying off our loans, right?
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And so to look at what could happen if the unimaginable happens, it's huge.
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And so many of us aren't taught about it.
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And if we are taught, it may not be to the fullest extent.
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And so there's a lot of misinformation.
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There's a lot of misunderstanding, and I kind of think it's on purpose.
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I think that insurance companies want us to be a little bit confused.
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And we don't have to be, you know, it's just, it's a different language.
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Speaking of language, I think we all have a general sense of what disability insurance
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is supposed to do for you, for us, but you found out that although you had disability
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coverage, it wasn't quite the coverage you hoped it would be.
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Speak more about that.
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So I already mentioned the group benefit had the fine print that it didn't cover work-related
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injuries.
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I will tell you back in 2012-13, that was definitely the exception to the rule.
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It's becoming more and more common, and to be honest, since the highest point of COVID,
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they're also putting in, now that they're not covering work-related injuries or illnesses,
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I find that to be a slippery slope.
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I'm not sure how anyone can prove where they contracted an illness from.
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And again, it's not everywhere, but the devil's in the details of these employer policies,
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and they don't really have to tell us what's in it.
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It's usually one line on your open enrollment packet and you check a box.
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So part of that is just, we don't know what we're supposed to ask for.
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And so everyone really should be getting a hold of the master copy of their employer's
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policy to figure out what do you have, what don't you have, where are there holes.
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So that's the first big piece that I had no idea.
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Secondly, I thought that I bought the right private policy, and I will tell you that language
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is actually the biggest issue in that there's no standardization of language in insurance,
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like there is in medicine and lots of every other fields.
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And I thought that I bought a truly specialty-specific policy that would cover me if I couldn't be
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an OB-GYN.
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Well, it turned out that I had two policies.
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One was the right policy, but didn't have any of the bells and whistles.
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It was just a clean benefit that I get once a month.
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It never changes.
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It doesn't have inflationary protection or anything like that.
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My second policy is specialty-specific by my occupation, but not necessarily by the
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definition of total disability.
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So let me take a step back.
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What you want a private policy to say is that you're considered totally disabled if you
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cannot do your job, regardless if you're gainfully employed in another occupation.
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Now most group benefits, instead of the word regardless, it's the word not.
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So you're considered totally disabled if you can't do your job and you're not gainfully
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employed.
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So that definition isn't great for most of us who are not hardwired to be stay-at-home
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parents.
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I have the utmost respect for them.
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I am not supposed to be one.
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And what my policy added was a clause that said until you make your pre-disability earnings.
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Now this one's a little hard to digest sometimes when we talk about disability insurance being
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income replacement protection.
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The issue is with that phrase, you lose your earning potential.
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So 11 years later, I still have to send in my banking statements and my company profit
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and loss statements for them to decide if they're going to pay me or not.
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And where it becomes a kicker is the company can do well, but I may not take a distribution.
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I still get dinged because I have equity in the company.
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So I can kind of get double screwed for lack of better phrasing because now I'm not taking
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money from the company because we do a lot of reinvesting in our people and our technology
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and all of that stuff.
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And now I'm not getting my benefit.
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And I thought I was going to be covered if I couldn't do the job that I did.
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And I think the way to make it make the most sense is think about yourself as a resident.
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You're nowhere near your earning ceiling.
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I bought that policy my first years in attending.
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I wasn't near my earning potential.
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And let's be clear, if I could make doing this what I made my last years in attending,
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would I need my insurance?
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Probably not.
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But it's a giant mental thing that it's not what I thought I bought.
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And if I had made that decision through informed consent, which I know really doesn't totally
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exist outside of medicine, but I try to make it, then that's on me.
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But it wasn't.
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It's not what I thought I got.
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And I would never sell a policy like that to somebody earlier in their career because
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things happen.
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I've had residents go out.
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I've had fellows go out.
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I've had very early attendings go out.
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And if they're not taking into account your future earning potential, you could be in
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a really bad spot.
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Yeah.
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So the situation seems...
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Oh, actually, I was going to say it seems bleak, and it does.
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But there's a ray of hope because that's why you're here, to help physicians think really
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about how they should be thinking about disability insurance and what coverage they should make
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sure they have.
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So I want you to speak first about own occupation disability.
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And I want you to speak especially to my audience.
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I mean, we're clinician researchers.
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We're like, well, if I can't see patients in the clinic, I'm just going to go do research.
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Can you speak to why people like me need to be thinking about disability insurance and
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that we're appropriately covered?
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Absolutely.
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So the first part, the comment of this is bleak, but look, like I said, I'm doing this
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now to try to change the industry.
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I know that that's a little bit hyperbolic, but I don't want to be...
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Or I should say, I don't want anyone else to go through what I went through.
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So I do see this as being bigger than me and my family or my family and me.
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As far as clinician researchers, I think that there is...
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And I don't mean to offend anybody, but I think there's a little bit of a misunderstanding
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or misconception that only proceduralists need to have disability insurance, right?
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If you don't use your hands, you don't need this.
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Well, first of all, that's not true.
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One, a lot of physician researchers use their hands and are very much proceduralists.
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I worked in a genetics lab for a long time, and if I couldn't use my hands, I would have
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been in a lot of trouble, right?
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But we're not talking about just using your hands.
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You guys really need to think about your brains probably more than anybody else.
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And there are a lot of things that knock that out that we just don't want to think about.
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There's a tyranny of perfection that lives in medicine, right?
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We're tougher than stronger than we're resilient than...
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Something bad's going to happen to us.
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That's just not true.
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And there are a lot of things...
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Look, think about outside of even basic traumatic brain injuries, right?
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So you have car accidents, ski accidents, bike accidents, during storms, tree branches,
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fall.
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I mean, they're not called widow makers for nothing.
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And think about all the things that cause fatigue, right?
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There are things where it's not you're going to wake up one day, be able to do your job,
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and wake up the next day and completely not be able to do your job.
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Think about things like MS, other autoimmune diseases, right?
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ALS, working through chemotherapy, things where a treating physician is going to say
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to you, look, you can actually do your job.
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So now I'm focusing more on that fatigue piece.
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You can do your job, but you can't do it sustainably.
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Well, you're going to lose money, right?
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And your policy should have something in it called a residual or partial disability benefit,
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which is going to kick in if you have to go part time.
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Now going back, and I might have done this a little out of order, I apologize, but you
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mentioned talk about the own occupation piece, and you'll maybe realize that I said specialty
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specific in the beginning, and that's because companies use different phrases to mean the
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same thing.
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And so what we hear kind of around the water pool is own occupation, own occupation, own
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occupation.
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But then you find out that other companies call it something else, or even worse, companies
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can call it own occupation, but define it differently.
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And that goes back to the group versus private.
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Most group policies will say that they're own occupation, and the assumption there is
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you're covered for what it is you do day in and day out.
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But when you go into the fine print of the policy, it may be what's called held to the
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national economy or the local labor market.
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It's not specific to what one employee does at one employer site.
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That allows them to cast a really wide net that says this is what you would, could, should
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be able to do based on your training, education, and skill set.
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So that's not really an ideal definition, but oh, it says it's own occupation.
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So it's almost a lie of omission, right?
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Whereas in the private sector, it can be called true own occupation, own occupation, regular
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occupation, that there's about five to seven different terms that are used, right?
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What you want to know is, in fact, are you covered for what it is you do day in and day
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out, not what your neighbor does?
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And will you be considered totally disabled if you can't do that, regardless if you're
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gainfully employed in another occupation?
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So I kind of went a little bit out of order there, but I think I got the point across
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if I didn't, you know, I'm certainly happy to delve into it a little bit more.
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But I truly think from a researcher standpoint, I think you have to think of yourselves as
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hands on.
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I do think you guys are proceduralists.
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I think that, you know, you have to protect your brains, you have to protect your stamina,
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right?
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Cancer doesn't discriminate.
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ALS doesn't discriminate, right?
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And that's just the tip of the iceberg.
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I mean, I can get, I have hundreds and hundreds of stories.
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I don't want to turn this into a fear mongering episode, but you guys have a specific skill
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set and that skill set needs to be protected.
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Thank you.
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Yeah.
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When you're talking about using our hands, I'm thinking I'm typing all the time.
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I need to be able to type.
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Even when you do voice to text, you still have to go back and do some editing.
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And clearly the brain, you don't even have to sell that at all.
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So okay, so we have a stab.
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Yeah, yeah.
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I left that out, but think about how much you read, how much you have to analyze.
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Blindness happens, right?
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Accidents happen.
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And so there are many things for you to be worried about.
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Sure.
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So, so now you've sold us on the necessity, right?
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We all agree.
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We should get disability policy, but what should we be looking for now that it sounds
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like every disability policy is not the one we want?
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So the short answer to that is there are five carriers that truly give the language that
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we need as physicians.
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So that's that.
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But beyond that, you want to make sure that the language is tight.
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You want to make sure that you can access additional coverage without having to go through
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medical underwriting again.
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So medical underwriting is part of most policies when you're trying to get it for the first
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time.
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And it's really invasive.
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I mean, you may have to pee in a cup.
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You may have to give up some blood.
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You absolutely have to answer a million medical questions a million times.
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They have access to your medical records, your pharmaceutical records, your motor vehicle
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records.
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You want to give that info once and never have to give it again.
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And all of these carriers have money sitting somewhere that you can access as your income
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ascends, as you change jobs and have different benefits, where all we have to do is show
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them proof of income.
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So I think that's probably the second most important part.
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And then you get into these smaller pieces.
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I had mentioned the partial or residual benefit.
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There are actually more partial slash residual claims filed and paid every year rather than
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total.
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So I think that was super important.
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There's inflationary protection that you can add.
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So it's known as the COLA or the cost of living adjustment.
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Now the interesting thing with that is that doesn't kick in until you're on claim.
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So you're sick or injured, they're paying you.
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When you hit your anniversary, that benefit will go up.
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And so as I mentioned, I'm approaching my 11th year out.
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I've gone up 10 times.
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So what I'm getting this year every month is not the same as what I got in 2013 every
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month.
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And that can amount to thousands and thousands of dollars over time.
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There is something called a catastrophic benefit, which is exactly what it sounds like.
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So in the event something awful happens and you're left unable to perform two or more
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of your activities of daily living without assistance, or you're severely cognitively
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impaired, you could get an additional benefit.
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So it's additive.
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Think of X plus Y. X is your monthly benefit, Y is the catastrophic benefit that we have
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seen utilized in some of our older clients.
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I know it can happen younger, but thankfully it hasn't happened with us yet.
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But I do think that's important as we get older and bad things happen.
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The biggest difference amongst the carriers right now has to do with how they treat mental
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health and substance abuse.
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And it is a very individualized topic.
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Some companies give you options.
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Some of them it's built into the policy.
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And so there's a lot of movement there.
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And one of the first questions I tend to ask people is how important is that coverage for
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you?
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You know, we know that there are some people that have really good support systems.
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They don't have any family history.
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They would seek care if they needed it.
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They might benefit from a lower benefit that usually comes with a discount.
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If you're somebody who's had a strong family history, who is concerned about that taking
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you out, then you have to expect that you're going to pay a little bit more to have that
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full coverage.
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And you might want to look at specific companies that do offer that.
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I can tell you back in 2005 when I got my policy, it was actually the only question
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that I thought to ask of.
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My mom was a very poorly controlled bipolar sufferer who had a late break.
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I was petrified that I was going to be in my 40s and have a psych break and have to
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leave.
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And at the time there were only two companies in the state of Pennsylvania that would cover
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OBGYNs for mental health for the length of the policy.
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So I only looked at those two companies.
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Wish I knew other questions to ask at the time, but that was the one.
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Thank you.
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That's a really, really good summary of the things that we should be thinking about.
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I think definitely physicians need more help and we're going to talk about how they can
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access help through you.
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But I think what I'm hearing you say is don't just accept whatever policy you're giving,
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ask questions, and make sure it's actually tailored to what you might need.
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That's important.
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Okay.
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All right.
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And group policy is if they're paid for by your employer, you have to have it.
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So it's something that you have to have.
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You might as well know what's in there, right?
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You can plan accordingly.
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And I don't know, I'd like to think that if my husband and I knew what we had and what
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we didn't have, that we would have planned differently.
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00:29:04,580 --> 00:29:06,740
Yeah, no, that's good.
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Getting informed is important.
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So we're kind of getting close to the end of the show.
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00:29:12,580 --> 00:29:16,820
I'm wondering what is an important aspect of disability insurance that we haven't talked
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about just yet?
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Wow, we haven't talked about.
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I don't know.
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We've hit the major pieces of the puzzle, which are called riders.
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And I explained why I think it's so important for researchers.
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There's more to talk about the differences between group policies and private policies,
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but that would probably be a talk for another day.
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There are a few really...
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I could say the big differences have to do with taxation, ownership, and language.
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So your employer's paying for a policy, any of the benefit that you would get would actually
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be considered taxable.
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And anything that you're paying for would be tax free because you're paying those tax
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dollars and the government hasn't quite figured out yet how to tax up some both sides.
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So big difference between money that's getting taxed and money that's not getting taxed.
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Ownership, as I mentioned, if you have an employer paid policy, you have to accept it,
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00:30:21,700 --> 00:30:26,260
but you have no control in creating it, keeping it.
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They're usually employment dependent, so if you change jobs, oftentimes it's not going
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to go with you.
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Whereas a private policy, it's yours.
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You should help create it.
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You get to control it.
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You get to keep it.
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00:30:40,240 --> 00:30:43,200
It's going to go with you wherever you go.
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And again, most importantly, as I mentioned before, has to do with the language and does
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it mean what it really says?
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How are they defining words or phrases?
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What are the limitations?
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And I think that's probably the one thing that we didn't really get into.
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Sure, sure.
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You know, it sounds like more help is needed.
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00:31:04,300 --> 00:31:09,700
So for those who are saying, huh, I need to figure out if I'm adequately covered or for
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those who don't have disability insurance yet, who are thinking about it, how can they
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find you?
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00:31:14,180 --> 00:31:19,060
Well, our website has a lot of frequently asked questions and information.
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00:31:19,060 --> 00:31:22,220
So PearsonRabbits.com.
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00:31:22,220 --> 00:31:25,580
Obviously I am on all socials.
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00:31:25,580 --> 00:31:29,180
I am my name, Stephanie Pearson.
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00:31:29,180 --> 00:31:33,580
Some of them, it's Stephanie Pearson MD, some it's PearsonRabbits.
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00:31:33,580 --> 00:31:37,820
But if you Google Stephanie Pearson, you'll find me out a lot.
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You can call the office 610-658-3251.
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I'm so accessible now.
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00:31:46,020 --> 00:31:47,020
Thank you, Stephanie.
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00:31:47,020 --> 00:31:50,020
And for those who are listening, I will put that in the show notes so that you have access
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to her information as well.
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00:31:52,340 --> 00:31:54,820
Stephanie, this is such an important conversation.
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I want to thank you for coming on and sharing your story and helping physicians.
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I so appreciate that you're very mission-minded and I think physicians are a group that absolutely
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need help.
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And I'm so glad that you're in this space helping us out.
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Thank you, Stephanie.
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00:32:09,660 --> 00:32:11,660
Oh, thank you so much for having me.
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I'm honored and humbled.
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And please don't forget you guys need this protection.
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Thank you, Stephanie.
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Thank you.
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00:32:22,700 --> 00:32:23,700
All right.
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All right, everyone.
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Thank you so much for tuning in.
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00:32:25,820 --> 00:32:32,940
I hope you have seen how important this is and definitely reach out to Stephanie, get
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the help you need, make sure you have the disability coverage that you need because
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we need to continue to be able to protect our income really for as long as we're working.
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So thank you all for tuning in and I look forward to seeing you again next time on the
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Clinician Researcher Podcast.
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Thanks for listening to this episode of the Clinician Researcher Podcast where academic
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clinicians learn the skills to build their own research program whether or not they have
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a mentor.
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If you found the information in this episode to be helpful, don't keep it all to yourself.
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Someone else needs to hear it.
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So take a minute right now and share it.
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As you share this episode, you become part of our mission to help launch a new generation
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of clinician researchers who make transformative discoveries that change the way we do healthcare.