Advising Doctor Clients In A Post-Pandemic World

The pandemic highlighted some of the gaps and limitations with some income-protection coverage

This article originally appeared in Advisor Magazine

With the COVID-19 vaccine available on a widespread basis now, Americans who are fully vaccinated are returning to a more normal day-to-day existence along CDC guidelines – which are continuing to become more relaxed. For doctors, the effects of the pandemic may last longer.

The Yale School of Public Health recently conducted a survey of thousands of healthcare workers. The results suggest worrying levels of depression and post-traumatic stress disorder (PTSD) due to the pandemic. Nearly 25% of all healthcare workers surveyed showed signs of probable PTSD, and nearly 50% exhibited signs of probable alcohol use disorder. Rachel Hennein, an M.D./Ph.D. student at Yale and a first author of the study, believes the results prove the existence of predictive factors that correlate with an increased risk of adverse mental health outcomes for doctors during the pandemic. The healthcare community, then, is at a higher-than-usual risk of experiencing burnout.

Benefits brokers and advisors can protect their doctor clients by ensuring their disability insurance covers mental health and substance abuse events that are disabling in nature. Many policies limit benefits or exclude these types of disabilities from coverage.

Determining Disability Insurance Policies That Best Suit Doctors

Doctors have high income levels, usually comprised of multiple income sources, and sometimes own practices or manage heavy debt from student loans. Like many other professionals, their financial solvency relies on their ability to work. Unlike many other professionals, losing the ability to work affects more than just their capacity to support themselves and their family; it sometimes affects the solvency of a medical practice or the doctor’s ability to meet their loan repayment obligations.

Doctors are also unique in that they often have very narrowly-defined medical specialties. These include broader specialties like anesthesiology, neurology, emergency medicine, radiation oncology, and more specifically defined sub-specialties like neuroradiology, medical toxicology, congenital cardiac surgery, and hematology. So a doctor needs a policy that defines a disability in a way that matches their exact medical specialty.

The ideal scenario is for the policy to use a claimant’s CPT/CDT-coded procedures to determine disability rather than a broad specialty. If the disability prevents the doctor from performing even one of their regularly performed CPT-coded procedures, they are considered totally disabled. Individual disability insurance (IDI) policies and certain IDI-like group long-term disability policies provide this specificity level.

Beyond this important policy definition, Mental & Nervous and Drug & Alcohol (MNDA) coverage must be part of the disability insurance conversation – even in non-pandemic years, when burnout is already high. Doctors benefit most from disability policies that offer: Mental & Nervous and Drug & Alcohol (MNDA) coverage must be part of the disability insurance conversation – even in non-pandemic years, when burnout is already high…

• MNDA benefits
  Some long-term disability (LTD) policies will not cover preexisting conditions, like major depression or anxiety disorders, and many MNDA disabilities can be recurring.
• No lifetime max on benefits
  Many LTD policies cap MNDA benefits at 24 months, which is insufficient for the field of medicine and its higher levels of stress.
• “Per occurrence” coverage
  Policies with this specific language can pay benefits if the doctor suffers a relapse or if the disability caused by burnout manifests differently.

Some LTD policies may also require stringent proof of a disability to start paying benefits. If an insurer requires examinations or rigorous interviews to pay on an MNDA-related incident, doctors can face an undesired compounding of additional stress and pressure.

Making Sure Your Doctor Clients Are Financially Prepared for Burnout

COVID-19 has opened many people’s eyes to the importance of coverage for all types of disabilities, both physical and mental. However, overworked doctors may have neglected to review their plans to ensure their expectations for policy payouts align with their policy language.

Questions to ask your clients during the pandemic and beyond to ensure adequate coverage for burnout-related disabilities include:

• Do all of their disability insurance policies offer MNDA coverage?
• Are the coverage amounts high enough to replace all income and cover any business expenses or student loans?
• Will the policies pay benefits on a relapse under the MNDA provisions? In what timeframe?
• Will the policies cover all possible mental and physical conditions that could be attributed to burnout and extreme work stress?
• Are there any preexisting condition exclusions that may affect their ability to collect benefits if they become disabled due to burnout?

Benefits brokers and advisors can earn their clients’ trust by working on grasping the realities of their day-to-day lives, their risks, and how much coverage they need. Consider this: The American Journal of Medicine cites specific concerns about burnout rates for various types of doctors. Their list includes family physicians, emergency room physicians, psychiatrists, anesthesiologists, cardiologists, radiologists, general internists, dermatologists, oncologists, general surgeons, gastroenterologists, trauma surgeons, obstetrician-gynecologists, and physiatrists.

Until doctors become more comfortable seeking early treatment without the fear of stigmas or professional repercussions, and until their workloads decrease to the point where they can take time to care for themselves, burnout will continue to be a risk factor for disability in the healthcare industry. Make sure your clients are covered through comprehensive disability plans you know are tailored to their specific needs.

Mr. Brunken is president of MGIS, a leading national insurance program manager that builds and manages specialized disability insurance programs for doctors.