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In our recent webinar “Transitioning From Training to Practice Successfully” we had a lot of great questions! So we wanted to provide some answers for you. Hopefully, there will be something here to help you as you transition from training to practice!
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That is a great, great question and the answer is, “Yes, you can.” Now, can you negotiate the same number of things into the degree that you would with a small private practice? No way! That's just totally different.
Will they change a lot? Probably not. But even if you've signed a contract with them, if there's something in there that really gets under your skin and bothers you, talk to them. And whether they do it in the contract or in some kind of context outside of the contract to make things better, they will listen to you.
So be sure that you don't just throw your hands up and say, “Whoever it is is too big, they're not going to listen to me,” we have found that generally, in almost every situation, to not be the case.
We're just entering the tenth year here where some people are starting to receive some payments from them, they're starting to pay off their loans.
Even if it's successful for the next 2 or 3 years, I don't know that I'm confident that 10 years from now, or even 7 or 8 years from now, that it's still going to be operating and doing what it should.
For those of you who are relying on public service loan forgiveness to get rid of your debt here in 10 years, I would still pay maybe a little more than is required, just in case we get there and they renege on that and you're left having to pay it off.
You don't want to be stuck with a huge debt burden as if you haven't paid anything on it. Don't put all your eggs in one basket, especially when it comes to a program instituted by the government.
Absolutely! If your employer offers coverage, that's pretty normal. You want to learn these things before you get disabled, not after.
We have people call and say, “Hey, why is my employer coverage only paying me 25% of my pay? They said 60%,” and have to tell them about it not being own occupation, having maximums on their benefit, and taxes being taken out first.
When they hear this, their first response is, “Well, I guess I should have gotten my own coverage to supplement it,” and that's exactly right. So even if you're getting coverage and it sounds pretty good, get a second opinion, let us show you how to match it up.
Make sure you get something to supplement it because all group insurance has deficiencies. We're talking about your life income, we don't want to mess this up and under-protect it.
As a resident, you have huge discounts available in training, massive discounts. If you miss them, you're looking at paying 25%, 30%, sometimes even up to almost double what you would pay with your discount, depending on your situation.
The nice thing is, even if you procrastinate and wait till the last second, you can actually learn about your options and apply for them but not pay for them until you're either closer to or into your attending position.
The general advice here would be yes. You don't want to sign anything necessarily and say that you're going to work there until you see the details in particulars of the contract.
I know that's tough coming out of training because you're saying, “Well, but what if it falls through and I don't get this position?”
But you may be better off in the long term not getting a position from an employer whose details you haven't seen yet. Because the worst thing to do would be to sign something and then get the details and find out you hosed yourself for the next three to five years with a really bad contract.
Be careful; you want to make sure you see everything you can before you sign it.
Whole Life Insurance is expensive. If you miss one single payment, most of the time, you lapse the policy, it triggers taxable gains, it is just not what it's cracked up to be.
If you want life insurance, either go the really cheap term route and rent it for a certain period of time.
Or if you want to try and get your money back and have something to build some money over time and that’ll last for your entire career or a lifetime, then look more towards Index Universal Life; you'll get a much better situation, I think.
For those of you who are making a lot of money, each disability policy has a maximum on it that may be anywhere from $15,000 to $20,000 a month.
If you're going to be making enough money that, on top of any group insurance from your employer and that amount of coverage, you still want more coverage, you can have multiple policies and it will let you go up to higher amounts like $30,000 between the two policies.
There is some utility, but you need to be in a higher income earning specialty to do that, and it needs to be a situation where you're going to want more than $15,000 or $20,000 a month.
Just know that each company treats every single medical situation differently. Even with anxiety or stress issues, if you've been on antidepressants or things like that, there can still be options for you to get very good discounted own-occupation disability insurance.
I wouldn't necessarily let past results or any medical conditions or any medications you're taking keep you from doing this. You still want to learn about your options and your discounts.
And more than likely, you will have at least one very good discounted option. So don't let that stop you from going ahead and chatting with us about it.
Typically, it might take a week to 2 weeks, depending on this complexity. Even if you've signed your contract, getting a real legitimate physician contract attorney to review it and educate you on what's in it, what's not, what should you maybe talk with the employer about, is still very, very, very valuable.
Most sign-on bonuses, signing bonuses, commencement bonuses, do have a repayment obligation with them.
Your income can have a repayment obligation on it. I've told the horror story many times about an orthopedic surgeon who received a contract for $500,000, got to his practice for his first year, didn't work a lot due to some issues, and ended up owing $300,000 back to the practice at the end of his first year out of training.
So make sure that you’re aware of any repayment obligations. Negotiate that out of there if you can. But if you can't, make sure that you're working your way into it. So if they give you a $20,000 signing bonus, and if you leave within 2 years, they're going to make you pay it all back, maybe make it where it steps down. If you make it through one year, now it's only $10,000, and by the end of the second year, then it goes away; or something like that. Make sure that it's prorated and steps down.
That is a great question. We would always recommend getting the coverage as earliest as possible, so if that means you are in training, you would want to get a smaller policy with an FIO rider or similar. (There are other increase riders with some companies that do not cost you anything to have on the policy)
When you do increase your policy once attending, you can always remove the FIO rider at that time as well. After that you no longer have to pay for the right to increase if you are already fully insured.
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