Managing Your Debt as a Healthcare Professional

by Lindsay Miller, BSN

It is estimated that the typical medical student graduates with over $200,000 in total student loan debt, counting that acquired during their undergraduate years. With first-year starting salaries for doctors starting as low as $50,000 or less in some geographic areas and fields, some students are left wondering if their medical degree will be worth the price of their education. Even nurses, who don’t have to worry about paying for the astronomically high tuition of med school, still hold nearly $30,000 in student debt themselves – not a small chunk of change by any stretch of the imagination.

Although most people naturally affiliate medical degrees and doctors with sky-high salaries, many doctors and other healthcare professionals choose work that is relatively low-paying but rewarding in other, non-financial ways. Whether that’s your particular situation, or you simply want to get a handle on your student loan repayment, here are several approaches for helping you manage your student loan debt.

Reduce Your Monthly Payments with IDR

According to Adventures in Education, if your income is relatively low compared to your level of student loan debt, look into the Federal Government’s Income-Driven Repayment (IDR) Plans. These plans, of which there are several options, allow borrowers to cap their monthly federal loan payments at either 10% or 15% of their discretionary monthly income. For some borrowers with very low income or a large family size, the monthly payment can be as low as $0/month no matter the size of their federal student debt. The caveat here is that IDR is only available for federal loans, and not for private ones. In order to reduce your monthly payment for private loans, it is necessary to refinance them at more favorable terms than you originally borrowed.

Consolidate your Student Loans with a Private Bank

According to LendEDU, consolidation, and refinancing is a debt management solution that applies to either private or federal loans. However, borrowers who refinance federal loans with a private lender need to be extra aware of the pros and cons of doing so. Federal loans automatically come with a slew of benefits hard to find in the private lender market, including forbearance, loan forgiveness, and the IDR plans discussed above. Once federal loans are refinanced, the only benefits available are those offered by the new, private lender. And loans that have been privately refinanced can never go back to being federal loans.

On the other hand, private loans should almost always be refinanced once a borrower has graduated and has an income. During school, rates were likely higher because a student has less credit history and little-to-no income. However, once they graduate and start working—even if still in a residency—they become a much more attractive credit risk to lenders. Student borrowers who got great rates in school either on their own or with the help of a creditworthy cosigner may not find that they can refinance for a better deal, but everyone else should investigate better rates within a few months after graduation. Not only can the interest rate go down, but payments will typically be lower since less interest will accrue each month.

Look into Loan Forgiveness

According to The Student Doctor Network, there are many options for loan forgiveness available to doctors and other healthcare professionals. For starters, the Federal Government offers a program known as Public Student Loan Forgiveness (PSLF) which offers complete forgiveness of remaining federal student loans after ten years of working for a qualifying entity and making monthly payments. Qualifying entities are typically state-sponsored hospitals and clinics or those that are set up as non-profits. The amazing thing about PSLF is that it can be combined with reduced monthly payments set up on an IDR plan. This allows a borrower to make reduced monthly payments for ten years and then have their remaining loan balance forgiven. Working in an area that is underserved by the medical profession also offers a route to loan forgiveness, and there are many state programs that offer their own loan forgiveness for health professionals willing to work in low-income and rural areas.

See What the Military Can Do for You

The military offers two general types of student loan help for medical students. The first is tuition assistance for service members who enroll in medical school and will become military doctors upon graduation and completion of their residency (the military branches also offer residencies in many VA hospitals). The second is loan forgiveness help for doctors who have already graduated and who enroll in the military to serve as doctors. Different branches offer their own forms of assistance and incentives, which can include loan repayment, monthly stipends which can be put toward student loan payments, and special grants.

Lindsay Miller is a recent graduate of the University of Wisconsin-Madison where she earned her BS in Nursing. Aside from her work as a nurse, she enjoys reading and writing about personal finance and figuring out the best strategies to repay her $37,000 in student loan debt.

Posted in Communication in Healthcare, Complexity in nursing, Healthy Workplaces, Nurse Entreprenuers, Nurse Leadership | Tagged , , , , | Leave a comment

Exciting News! Wendell Potter’s Journalism Project (Tarbell) to Educate Us About Important Issues!

By Meg Helgert, FNP

Wendell Potter will bring to light new information regarding the millions of dollars flowing between health insurance companies and politicians on the Hill. This is where Citizens United will need to be brought down and illuminate the kind of pressure lobbyists bring to bear on our government officials. Money much of us do not have to peddle influence. He has been leader in a large health insurance company and saw firsthand people waiting in line for hours to get free health care which changed his mind forever regarding what needs to be done.

Check out RJ Eskow’s video interview with Wendell Potter on youtube!

I highly recommend health care providers donate to Tarbell and help shape health care policy along the way.  (Twitter  and Facebook )!

Why the name, Tarbell?

Their guiding spirit is Ida Minerva Tarbell, one of the most important journalists in American history. Ida was the first of a group of early 20th century “muckrakers.” Their investigative reporting of the corporate titans of the Gilded Age contributed to the forced breakup of huge monopolies and also to important antitrust laws and campaign finance reforms. They aim to do her proud.

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Passive, Aggressive, & Passive-aggressive Behaviors as a Consequence of Lack of Listening

Assertiveness is not only about speaking up, ironically it is also about listening and being heard. Being assertive means speaking up about your own needs while being respectful of others.  As such, there is an inherent relationship involved in any assertive behavior.

Really, you can’t be assertive by yourself! 🙂

This is partly why assertiveness can get complicated.  Think about this for a minute.  If you speak up to someone and they don’t respond, what might you do?  Try again and speak louder?  Maybe do something like tap them on the shoulder or make a noise to get their attention? If that works, great, you can continue on with your conversation.  But what do you do if it becomes apparent that the person you are trying to speak too is ignoring you?

  • Grab them and scream?
  • Talk about how you were ignored to others behind the person’s back?
  • Forget about speaking up to this person, ever.

See how these responses could be labeled aggressive, passive-aggressive, and passive? Even though they might not be mature reactions, they might be understandable when someone is feeling ignored. Especially if this is a chronic pattern. Something to think about in terms of creating and sustaining cultures of safety, right?

Nurses are required to be assertive for patients’ needs, but that doesn’t mean they shouldn’t be assertive for their own needs too. The more you explore assertiveness as a behavior that occurs in relationship, the more you will see how complex it is!

If you are curious about the relevance of this concept in healthcare, check out these two posts:

Using Validation to Honor Folks with Dementia and Avoid Power struggles!

Here’s a 3rd and Essential Step for the Two Challenge Rule

And let me know what you think!

Posted in Assertiveness, Communication in Healthcare, Complexity in nursing, Diversity, Healthy Workplaces, Listening, Patient Advocacy, Patient Safety | Tagged , , , , | Leave a comment