“You never realize the value of something, until it is gone.”
– Anonymous
Every year, medical school graduates enter the ranks of hospital staff as newly minted interns. They quickly become accustomed to various workflows, while learning how to be efficient, balance several tasks at once, triage emergencies and maybe even save a life. Neurosurgery is no exception. Throughout the COVID pandemic, neurosurgery has been one of the few surgical fields that carries the privilege of continuing operations. An intubated patient with subarachnoid hemorrhage and hydrocephalus being transferred? We will gladly grab our N95 masks, don PPE and place the EVD.
True emergencies in neurosurgery cannot wait for treatment. Minutes and millimeters can mean a world of difference in patient outcomes. This is precisely why our careers depend heavily on not only our ability to think critically, but also on our surgical skills. Disability or impairment could threaten our very futures. It wasn’t until the COVID pandemic and hospitalization of health care workers that my colleagues truly appreciated the impact that illness and disability could have on one’s surgical career. As a result, disability insurance has become more relevant now than ever before.
Disability insurance is a type of insurance that protects the ability to earn an income if one loses the ability to work. For neurosurgeons, whose livelihood depends on manual dexterity, ability to triage patients, and operate under extreme pressure, disability insurance is invaluable. Although disability insurance does not entirely replace your paycheck, some advantages include tax-free disbursement, ability to increase policy limits at the end of residency, and student loan coverage options.
Disability insurance comes in a few forms and is available from multiple vendors. One option is the employer’s disability insurance option. Most interns may sign up for disability insurance as part of their residency orientation. This is usually in the form of a group disability policy. Oftentimes, the requirements that define disability according to these policies are non-negotiable, are not specialty-specific, and may not meet the needs of policyholder’s unique circumstances. I encourage every resident to review these policies closely.
The other option is to purchase disability insurance from an individual agent. The ideal agent is familiar with surgeon specific policies and can provide a range of estimates based on custom policies and policy riders. The ideal agent is accessible and affable; typically they are recommended by a senior collegues. It is important to note that agents should be able to offer policies from at least some of the “major” disability insurance firms such as Standard, Guardian/Berkshire, Principal, Ameritas/Union Central and Mass Mutual.
As neurosurgeons-in-training, our ability to perform procedures is paramount. Therefore, it is imperative that the policy you choose is a “true own occupation” policy. This is a policy designed for specialists. Many true own occupation policies define disability as an inability to operate and some policies can be further customized to define full disability as an inability to operate less than a certain percentage of clinical time. One of the major advantages of true own occupation disability insurance is that one can still be employed in other sectors while being considered fully disabled and receiving monthly payments.
Another advantage of this custom policy is the ability to add “riders,” options that boost coverage. One example is a student loan rider. As residents, the burden of medical school loans can be overwhelming. Disability that results in lost income can make repaying loans impossible. By adding this specific rider to your coverage, your disability disbursement can ensure coverage of expenses including the cost of living as well as loan payments. Each added option can result in hefty premium increases, which is something to keep in mind when considering your personal finances as a graduating medical student.
It is well accepted that doctors make the worst patients; a corollary to this is that in order to effectively take care of patients, physicians must first be able to take care of themselves. Emotional, physical and financial health all make good sense for the neurosurgeon.
