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  • The Disability Insurance Window Most Physicians Don’t See Closing [Podcast]

    The Disability Insurance Window Most Physicians Don’t See Closing [Podcast]
    Jan 20 2026
    A physician told me he thinks about disability insurance for physicians the same way he thinks about a dashboard warning light: by the time it flashes, you’re already behind the ball. That line landed harder than I expected, because it came from someone who lives on the other side of the exam room. In a recorded conversation for The Income Protection Podcast, I spoke with Dr. Isheet Patel, a board-certified internal medicine physician and co-founder of a concierge practice in Lone Tree, Colorado. I went into the interview looking for a straightforward answer to a simple question: what actually takes high-performing professionals out of work? What I got instead was a framework that felt almost unsettling in how ordinary it was. Not a freak accident. Not a rare diagnosis. Not the dramatic headline story we all assume we’ll recognize in time. He described something quieter: years of “micro-decisions” that don’t hurt today, don’t show up in a calendar reminder, and don’t trigger panic—until they do. When I asked what most commonly threatens a professional’s ability to work, he didn’t start with a list of catastrophic events. He started with the way modern life makes it easy to drift. A once-a-year physical. A few lab numbers you glance at and forget. Habits that become normal because they’re common. Then, one day, a diagnosis arrives as if it came out of nowhere. He kept returning to metabolic disease—pre-diabetes, fatty liver, high cholesterol, obesity—and the way these conditions can “creep in on you,” as he put it, without a sensation attached. No sharp pain. No obvious moment when things changed. Just a long runway where the consequences are accumulating offstage. The part I didn’t expect was how directly he connected that slow drift to career risk. Not only because illness can interrupt work, but because it can change what becomes available to you financially, and when. If you’ve ever assumed you’ll deal with protection later—once you’re established, once your income is higher, once life is less hectic—this is the episode where you’ll hear why that assumption breaks down in real life, not in theory. One of the most revealing moments in our conversation wasn’t even a statistic. It was his insistence that the body doesn’t wait for your timeline. A single slip in the tub. One car crash. A surgery that’s supposed to be routine until it isn’t. He described a patient who went in for a hysterectomy and, at 44, discovered cancer “spread everywhere,” with no warning signs. When he said it, there was no drama in his voice—just the bluntness of someone who has watched “normal” turn into “before” and “after” in a single appointment. That’s the point where listening matters. On the page, it’s easy to skim past a sentence like that and tell yourself it’s an outlier. In the audio, you can hear how quickly the example comes to him, and what that implies about how often he sees life rerouted without notice. Where prevention gets mistaken for control Dr. Patel was careful not to sell a fantasy of perfect prevention. He talked about genetics, bad luck, and the reality that sometimes “the cards are dealt.” What he challenged was the belief that you’ll always get a clean warning before something becomes serious. He described what I think a lot of high-income professionals do instinctively: treat health like a responsibility you can postpone as long as performance stays high. He framed it as a kind of delayed accountability. Years of neglect don’t always feel like neglect. They feel like being busy. Being committed. Being productive. Then “one day, boom,” you’re dealing with the compounding result. That “boom” is not just a health event. It can be a financial event, too. Chronic diseases don’t only change how you feel; they can change how you’re evaluated. The underwriting process isn’t sentimental. It’s documentation and risk, and people “typically don’t get healthier as time goes on,” as I said in our conversation. In other words, waiting doesn’t just increase the chance you’ll need coverage. It can increase the chance you won’t be able to get the kind you wanted. The episode isn’t a lecture about perfect living. It’s more sobering than that. It’s about the difference between being functional and being safe. Many professionals are functional right up until they aren’t. And the interval between those two states can be shorter than anyone wants to admit. Dr. Patel also took a sharp turn into something I hear constantly from physicians and other medical professionals: stress isn’t only emotional. He described chronic stress as corrosive—something that changes hormones, immunity, recovery, and risk. “Happy people live longer” isn’t, in his framing, about positivity. It’s about how well someone can manage stress, create boundaries, and recover. That aligns with what the CDC states plainly: ...
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    30 Min.
  • When Disability Insurance Leaves High Earners Exposed [Podcast]

    When Disability Insurance Leaves High Earners Exposed [Podcast]
    Jan 13 2026
    There’s a point in some careers when protection that once felt solid starts to feel thin. Nothing has gone wrong yet. No diagnosis. No accident. Just a quiet realization that the numbers no longer line up the way you assumed they would. That tension came up repeatedly in my recent conversation on The Income Protection Podcast, where I sat down with Tom Petersen, a senior partner at Petersen International Underwriters. We weren’t setting out to talk about physicians specifically. We were talking about athletes, entertainers, founders, and people whose income behaves in unconventional ways. But the further we went, the clearer it became that many physicians encounter the same moment — often without realizing it. Petersen works in the specialty disability market through Lloyd’s of London, an area designed for situations that don’t fit neatly inside traditional policy limits. As he described it, this world exists where income is high, contracts are complex, and standard assumptions quietly break down. Listening to him explain how those gaps form made me think about how often doctors assume that having a policy means having enough protection. He pointed to a threshold that surprises people. Not extreme wealth. Not celebrity income. A level where success accelerates, obligations harden, and the percentage of income actually protected begins to shrink. Above that point, coverage may still exist, but it stops scaling with real life. What changes how this lands is hearing him talk about speed. Petersen shared how an accident abruptly ended his own ability to work and how quickly income evaporated once production stopped. Within months, the business he had built was gone. It wasn’t a physician story, but it carried the same lesson: when income disappears, life doesn’t pause to give you time to adjust. Where protection quietly stops scaling Most physician disability insurance conversations focus on technical choices — own-occupation language, benefit periods, elimination periods, riders. Those decisions matter. But Petersen kept returning to proportion. As income rises, lifestyles and commitments tend to rise with it. Housing, practice expenses, staff, long-term planning — none of these flatten simply because income is interrupted. Yet many high earners discover too late that the share of income they’ve actually protected is smaller than they assumed. That’s where the conversation shifts from income replacement to asset protection. Petersen pushed back on the idea that insurance exists only to cover monthly bills. In his view, it also exists to prevent forced liquidation — selling assets, unwinding structures, or making irreversible decisions under pressure. This is where the discussion intersects directly with disability insurance for physicians. Many doctors have strong base coverage from traditional carriers. Fewer have stepped back to ask whether that coverage still reflects the complexity of their financial lives as income, responsibilities, and exposure evolve. Why specialty underwriting looks at risk differently Petersen’s firm typically layers coverage on top of existing policies rather than replacing them. The goal isn’t to redo what works, but to extend protection where standard participation limits end. What stood out was how differently risk is evaluated. Specialty policies are often written for shorter terms and revisited, rather than locked in for decades. That flexibility creates room for solutions when income structure, medical history, or occupational nuance makes traditional underwriting difficult. He was candid about exclusions as well — not as deal-breakers, but as tools. Excluding specific conditions can still leave meaningful protection for everything else that could derail a career. Listening to him explain this in real time reframes exclusions from rejection to engineering. The specialty market’s time horizon also matters. Petersen described underwriting that focuses on what’s likely to happen in the next year or two, not the next twenty. For physicians accustomed to long-duration planning, this perspective can feel unfamiliar — but it explains why some people can secure coverage now and reposition later. What you don’t fully get from a written summary is how calmly he describes these dynamics. There’s no alarmism. Just a steady explanation of how success can outpace assumptions. The most revealing moments in the episode come not from definitions, but from the way he walks through examples and pauses before answering questions that don’t have neat edges. The reason to listen to this episode of The Income Protection Podcast isn’t to memorize policy features. It’s to hear how someone who works at the edge of the market explains the moment when income protection stops feeling adequate — and why that realization usually arrives later than it should.
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    51 Min.
  • The Scan He Wasn’t Supposed to See [Podcast]

    The Scan He Wasn’t Supposed to See [Podcast]
    Jan 6 2026
    Disability insurance for physicians is easy to think about in abstract terms until the moment your own health forces the issue. I was reminded of that in a recent episode of THE Income Protection Podcast, when I spoke with Dr. Peter Crane, a rural family physician in Idaho, about the night he accidentally opened his own CT scan while working an emergency department shift. I’m Jamie Fleischner, CLU, ChFC, LUTCF, and I host the podcast. Over the years, I’ve spoken with countless physicians about income risk, but this conversation unfolded differently from the start. Peter wasn’t sitting in a waiting room when he learned something was wrong. He was on the job, caring for other people, when a radiology report came through. Out of habit, he clicked. Only then did he realize the scan on his screen was his. What the image showed was not subtle. A 28-centimeter sarcoma, roughly the size of a football, filled the left side of his abdomen. He describes that moment without melodrama, almost clinically, which somehow makes it more unsettling. He had gone to bed feeling fine. He had been exercising. He was doing what physicians are taught to do. Yet there it was, undeniable, revealed in the same PACS system he used every day to interpret other people’s crises. As Peter tells it, the most disturbing part wasn’t the diagnosis itself but the realization of how long his body had been signaling something he had not allowed himself to see. Aside from a modest weight loss, there were no obvious symptoms. Only later, looking back at photographs, did he recognize the gauntness that had crept in over more than a year. It’s a detail that lingers, because it exposes how easily even medically trained professionals can normalize warning signs when life is busy and responsibility is constant. When we moved into how the diagnosis affected his work, the story became even more revealing. Peter practices in a rural community where coverage is thin and absence is felt immediately. Instead of stepping away, he tried to keep going. Radiation treatments required a long drive, so he left early, received treatment, drove back, and aimed to be at work by midmorning. At the time, he framed it as toughness. In hindsight, he calls it foolish. What he was really doing was trying not to surrender his role as the reliable one, the physician who shows up no matter what. The only time he truly stopped was after surgery, and even then it came with conditions. A surgeon who had once been his medical school preceptor agreed to operate only after extracting a promise that he would take six full weeks off. She understood something many physicians struggle to accept about themselves: the instinct to return too soon is not courage, it’s habit. That instinct, as our conversation made clear, is closely tied to how physicians think about disability insurance. Peter had an individual, medically underwritten disability policy purchased early in his career, shortly after residency. He did not end up filing a claim during that initial period, largely because he used accumulated sick leave and returned to work relatively quickly. From a narrow financial perspective, the policy stayed quiet. From a broader perspective, it mattered enormously. Once the cancer diagnosis was in his medical record, underwriting doors closed. There was no opportunity to shop for better terms, no chance to increase coverage, no ability to rethink decisions made a decade earlier. The policy he already had became the policy he would always have. As he talked about this on the podcast, there was a pause that doesn’t translate well on paper. You can hear him realizing, in real time, how permanent those early choices were. When Coverage Freezes in Time One of the most instructive moments in our discussion came when Peter admitted that he had never really revisited his coverage as his career advanced. He paid the premiums. He accepted incremental increases. Meanwhile, his income grew, his responsibilities expanded, and the gap between what the policy was designed to replace and what it would actually replace widened without him noticing. Only after his diagnosis did he look back and wish he had periodically asked whether the coverage would still approximate the income replacement people often assume disability insurance provides. That regret is not unusual. Many physicians treat insurance decisions as administrative tasks rather than living strategies. Listening to Peter describe this out loud, you hear how easy it is to confuse diligence with adequacy. He did everything “right” by conventional standards, and still found himself wishing he had been more intentional. Our conversation also moved into territory that rarely makes it into tidy articles about income protection. Peter spoke about filling out disability paperwork for his own patients and how, before his illness, it often felt like an unwelcome administrative burden. After becoming a patient himself, he sees those ...
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    36 Min.
  • Why Midlife Income Protection Depends More on Timing Than Assets [Podcast]

    Why Midlife Income Protection Depends More on Timing Than Assets [Podcast]
    Dec 16 2025
    Most people in their fifties and early sixties think income protection means safeguarding earnings during their working years. But on the latest Income Protection Podcast, MassMutual’s Marcus Watson explains why the real pressure point comes later — when income stops, responsibilities continue, and the financial path a family takes depends entirely on which version of the future arrives first. The sequence of events, not just the events themselves, is what determines whether a household preserves savings, absorbs a major care expense, or unintentionally jeopardizes the legacy they’ve spent decades building. That friction between uncertainty and planning is why income protection is no longer just about disability during working years. It now stretches into retirement, long-term care, cognitive decline and the financial realities of living longer than previous generations. Federal researchers note that “musculoskeletal conditions are the leading contributor to disability worldwide,” according to the National Institutes of Health, and those impairments rarely arrive on a predictable timeline. Watson uses real cases — including a 56-year-old emergency physician supporting aging parents and grown children — to show how income protection becomes a moving target when life events unfold out of order. The episode breaks down how families navigate three competing futures: living a long life, facing a health event that erodes independence, or dying earlier than expected. Each outcome affects income in a different way, and Watson explains why the transition from earning to withdrawing is often the most fragile stage. His own father’s sudden cognitive impairment at 53, triggered by a melanoma brain tumor, illustrates how quickly income can disappear even when retirement is decades away. As health-care costs rise, families are redefining income protection as a lifelong strategy rather than a short-term safety net. Longevity, impairment and financial responsibility are converging in a way that forces households to bolster their protection in the years leading up to retirement, not after the fact. That shift is also reflected in federal projections that “the number of people living with Alzheimer’s disease is expected to nearly triple by 2060,” according to the Centers for Disease Control and Prevention (), widening the gap between what families expect and what they must prepare for. By the end of the episode, it becomes clear why income protection has become the backbone of midlife financial planning — and why tools that tie together protection, care funding and legacy considerations are taking center stage. The details behind these strategies, however, unfold best in Watson’s own words, making the full conversation essential listening for anyone planning the next decade of their financial life. https://www.youtube.com/watch?v=ki4BUiyaDb0
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    28 Min.
  • Most High-Income Professionals Are Underinsured — And Don’t Realize It [Podcast]

    Most High-Income Professionals Are Underinsured — And Don’t Realize It [Podcast]
    Dec 9 2025
    As a disability-insurance specialist, I meet high-earning professionals every day who carefully insure their homes, cars and health needs, yet overlook the one asset that makes everything else possible: their income. The ability to get up in the morning and earn a living underpins every financial decision a household makes. When that ability disappears, even temporarily, the effects are immediate and far-reaching. That reality is at the heart of a conversation I’m having on the latest episode of the Income Protection Podcast, produced by Income Protection Journal. I’m speaking with Michael Sir, the president and co-founder of One Protection, about why income protection remains misunderstood and why so many people underestimate the risk. What becomes clear in our discussion is that most individuals have never stopped to calculate the true value of their future earnings—an oversight that puts their entire financial plan at risk. In the episode, Sir walks through a simple example. A 35-year-old earning $300,000 today, with modest income growth each year, will earn close to $20 million by retirement. Economists call this a person’s “human life value,” and it is almost always the largest asset a household has. Yet it is the asset people insure the least. If someone purchased a $20 million home, insurance would be required. But when it comes to protecting $20 million in future income, most people delay the decision or assume their employer benefits will be enough. That assumption rarely holds. As I explain on the podcast, employer-provided long-term disability plans often replace only a portion of income and usually cap benefits far below what high-earning professionals bring home each month. Because employer-paid benefits are taxable, the real income gap widens further. The definitions built into group plans also create problems. Partial disability is often not covered, and “own-occupation” protection—which is critical for physicians and other specialists—is usually missing. The shortfall can be significant. Using the example from the episode, someone taking home around $18,000 a month would receive only about $7,200 under a typical group plan. The remaining $10,800 must come from savings. I’ve seen families bridge that gap by draining retirement accounts, dipping into college savings or taking on debt. Health-related income loss remains one of the leading causes of bankruptcy and home foreclosure in the United States, and the pattern often begins with a single disabling event. Optimism bias drives much of this. People tend to believe that serious illness or injury is unlikely to happen to them. But disabilities during working years occur more frequently than premature death. And when income stops, expenses often rise. Health insurance costs can jump under COBRA. Out-of-pocket medical bills escalate. Sometimes a spouse or partner must reduce their work hours to provide care. The financial consequences ripple outward. Over time, the damage reaches beyond the immediate crisis. Once a disability occurs, retirement saving stops. College planning freezes. Emergency reserves begin to drain. Even well-prepared households can find themselves destabilized, not because they made poor financial decisions, but because an uninsured income event destroyed the foundation their financial plan depends on. This is precisely what individual disability insurance is designed to prevent. A well-structured policy can replace a meaningful portion of tax-free income and protect a professional’s ability to work in their own occupation. Individual coverage stays with the insured regardless of employment changes and can continue through retirement age. On the podcast, Sir and I discuss why these policies are especially important for physicians, attorneys, business owners and other high-earning professionals whose financial trajectory depends heavily on their ability to work. Still, disability insurance can feel abstract until people see the numbers clearly. That is where One Protection’s software becomes helpful. During the episode, Sir demonstrates how visualizing the projected lifetime value of income, the size of the gap caused by a disabling event and the long-term consequences of lost earnings changes the conversation. Many of my clients only grasp the full scope of their risk once they see the data displayed in a format that mirrors real life. One of the concerns we address in the episode is how seldom the industry raises this topic openly. Many financial advisors acknowledge the importance of income protection but fail to initiate the conversation. Some are unsure how to explain the nuances; others assume employer benefits are sufficient. As a result, consumers often do not receive the guidance they need. The message of the episode—and the reason I’m sharing it with readers now—is straightforward. A person’s ability to earn an income is the foundation of every financial plan. If that ...
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    37 Min.