[00:00:00] Thank you for tuning in to newly erupted pediatric dental conversations brought to you by the American Academy of pediatric dentistry, a podcast for pediatric dental residents, pediatric dentists, new to the field and dentists who are constantly seeking new information. Thank you to our platform sponsors, Cheng crowns, Denovo dental. Dox Pedo, Pacific dental and my kid's dentist and orthodontics and Treloar and heisel. This podcast is possible because of their support.

[00:00:42] Joel: [00:00:42] We are here today with Dr. Alene. D’Alessio Dr. D’Alessio is currently the division chief for the department of pediatric dentistry at university of Pittsburgh medical center, Children's hospital of Pittsburgh. She previously served as residency program director for six years there as well. She received her undergraduate degree from the university of Florida, her dental degree at the university of Pittsburgh school of dental medicine and completed her residency at UPFC children's hospital of Pittsburgh.

[00:01:08] Dr. D Alessio is an entrepreneur at heart. She holds five patents. We'll talk to her about that and has developed two products. One to help children wean from the pacifier called freeda baby pacifier weaning system. Look forward to hearing about that another time and also one to help children wean from a sippy cup stick with my stay put cups, stick with me, stay put cup, love the names. Dr. D’Alessio resides in Pittsburgh, Pennsylvania with her husband, Jason and their four daughters. Thanks for being with us today, Dr. D’Alessio really appreciate it

[00:01:42] alene: [00:01:42] I really appreciate it.

[00:01:44] Joel: [00:01:44] So to start out, you know, today our topic is insurance and for the young pediatric dentist, uh, the resident about to go into practice something they may not be thinking about. Although, you know, the programs get introduced to disability insurance. There are a variety of insurances to protect us throughout our career. And we need to start when we're young in the career thinking about it. So before we get into that topic specifically, How have you become interested and developed your expertise in various insurances?

[00:02:16] alene: [00:02:16] Sure. I feel like it wasn't that long ago that I was a resident myself. And I remember thinking, Oh, I'm fine. I can live off this resident salary. And soon life changes relatively quickly and you get married. You have A child, then you might have four children living at home with you. So your needs change throughout time as well.

[00:02:41] So that's when I really realized that I needed help in doing this. And we had experts come in when I was a resident at children's hospital, Pittsburgh, and I was very grateful that we did. I know pediatric dentistry really well. And knew nothing about insurance and having someone that specializes in dental specialties really made me feel great.

[00:03:07] They didn't know just the Pittsburgh or Pennsylvania area. They knew nationwide what was happening in different areas of different dental specialties. So it made me feel very confident with my choice in going with someone that specializes in this, because what I initially thought that I'd be fine. With minimal coverage, your life then changes and you need to protect not just yourself, but your family as well.

[00:03:34] Joel: [00:03:34] So when they came to you in that, in, during your residency program, as you said they talked about disability insurance, or did they also talk about other insurances?

[00:03:44] alene: [00:03:44] It's not just disability or liability, which I would say would be the two main topics that are on residents' minds as they should be. But I hand out to every resident, just a budgeting worksheet, talking about different scenarios and how to plan for the future, how to plan for the unexpected. And then things that we already know about, you know, you have your car insurance, your homeowners insurance, but you don't realize how quickly all of that adds up.

[00:04:12] So when they have that written down right in front of them, black and white, I think residents. I see. Okay, well, this money needs to go here and I need to save for this and do this. It just establishes healthy habits, financial habits early on, because once you start making, you know, more financially. It can, it could be dispersed and not all the proper ways. So I think establishing those habits early on with the expert help is the way to go.

[00:04:43] Joel: [00:04:43] So I, so I want to ask you specifically about disability insurance, because it's such an important one and we have a limited time and there's so much we could talk about, but I want to cover a lot of different types of insurance with you. So why is disability insurance important? You kind of covered it. It seems obvious. Maybe you can give an example of where it would benefit some one.

[00:05:02] alene: [00:05:02] Sure we've had residents come in that have had concerns for back problems, shoulder problems, all of these things, you know, we have avid skiers, snowboarders people that want to live their life and do fun things.

[00:05:18] And you want to make sure that you're protected because as your needs grow and change, your lifestyle is going to change as well. So you want to make sure that you are protected and I can't recommend enough to get that protection. Get as much as you can as early as you can, because you're going to get the discount, not just even a dental student discount, but a lot of times they'll have dental specialty discounts for the residents.

[00:05:45] So we make sure that our residents can have that coverage and have that benefit as early. Early on as they can, because you're probably going to be at your youngest and healthiest state at that point during residency. So typically they're going to be wanting you to look for something that's non-cancelable and a guaranteed renewable policy. So what that means, because sometimes this can all seem foreign to people, but as long as you pay your premiums on time, that price structure is going to stay the same.

[00:06:21] Joel: [00:06:21] So it's not going to get any cheaper. Let's put it that way as you get older, it's the best time to get it right, is as soon as possible.

[00:06:27] alene: [00:06:27] So I would say that that would be one big piece of advice that I would give to any resident that's looking

[00:06:36] Joel: [00:06:36] So malpractice insurance, or more properly professional liability insurance is something that everybody needs to have it's required in most instances. Um, just talk briefly about what we may not know about the need for professional liability insurance.

[00:06:51] alene: [00:06:51] Well, I, I do believe that everyone would know we should have it and we do need it. You want to protect everything that you've worked so hard to do. So there's two different types of coverage and you could have the occurrence and the claims made. So the occurrence will give you the lifetime coverage and claims made is only going to be within the policies timeframe.

[00:07:18] So you really want to take, I would say my biggest piece of advice with liability or, the malpractice would be just to make sure that you have that coverage. And you also have to think about, um, if you are in a big corporation, do you want extra coverage as well? If you're moonlighting, you absolutely need to make sure that you have malpractice insurance.

[00:07:46] So sometimes our residents are going out and moonlighting. Please don't do that without having that coverage outside of the facility that you are actually enrolled in because that's not going to protect you likely your policy is not going to protect you outside of where you're a resident at. So sometimes that can take quite some time, you know, to get to as soon as where are you going to be working out when you graduate from residency? Start that process, get that taken care of as soon as you know, the location of where you're going to be in the future.

[00:08:21] Joel: [00:08:21] So when we talked before about disability insurance, that covers you, the practitioner as an individual in the event, you were disabled and can't practice. What about the expenses of the business? There's something called business, overhead expense disability. Talk a little bit about that and why that's important for, is it important for everybody?

[00:08:41] alene: [00:08:41] Sure. So it is important. I think all of these, you know, it's almost like a gamble. How much are you willing to risk? And I think as I get more into my career, the less I'm willing to risk.

[00:08:56] So I do have quite a bit of coverage. It depends on where you're at though. So a business overhead expense. Is something where you might want that. You're not going to be protected with an ongoing practice expense just with your disability. So it's designed to cover fixed business expenses that you can't recover or sell on the business.

[00:09:20] Maybe staff salaries, taxes, utilities, things like that, that aren't going to be covered elsewhere. So if you're in a hospital setting, I'm in a hospital setting, so that might be something that the hospital's covered. So I don't have a business overhead expense, but if I was out in private practice, this would be one that I would definitely be looking at to have covered.

[00:09:45] You know, get the coverage for this owner's policy is basically like a homeowner's policy, but for your practice. So if you have homeowners, why wouldn't you want that business owner's policy?

[00:09:59] Joel: [00:09:59] That's terrific. We went, I'll pause for a word from our sponsor. We are back with Dr. Alene D’Alesio and we're talking about the various insurances that particularly young pediatric dentists residents who are about to go into practice should be thinking about.

[00:10:13] And we really appreciate the advice, the information you're giving us, because I recall, as you said, it was longer ago for me than it is for you, but it's still. On my mind. You're thinking about practice. You're thinking about your next part of your career and not thinking about all these things that you need to protect yourself with.

[00:10:30] So to continue along that line, that, you know, there's one, I have a friend who,  is a prominent pediatric dentist in the Midwest and who had a data breach. Uh, somebody hacked into the systems and crashed and, you know, they did the hostage taking thing, shut down the practice, several locations of our practice.

[00:10:52] And it happened to a lot of practices who subscribed to this particular service. So tell us about data breach and how big of a problem it is. And what can you do insurance wise to protect yourself?

[00:11:03] alene: [00:11:03] Sure. And that's very concerning. I know someone very close to me that had the same experience that you're talking to.

[00:11:09] We're talking coast to coast here. Now this is becoming a major problem. We have sensitive patient information, electronic billing and medical records. So there's a lot of patient information that goes out there. And it could happen with a click of a button. You think that it's something related to your practice and a front desk staff might just click a button and then all of a sudden you have a cyber attack.

[00:11:35] So there is a data breach. There's a policy that a data breach coverage can help mitigate some of those costs. And. Really more importantly, some potential litigation, which is the biggest concern. I think when you have a data breach like this, so it's, it's devastating and I'm sure your friend experienced the same, you know, it's, it's a game changer when that happens.

[00:11:59] Joel: [00:11:59] He is. And it's, I mean, not only is it shut your practice down just like bad weather would or something, but it also, you know, is, is relates to the sustainability of the data and the ability to access data. I can't even imagine them as electronic AIDS showing up to office one day and you know, I can't see the schedule or, you know, what do you do?

[00:12:19] It's just freaky, a scary thought to me. Uh, but anyway, yeah, so data breach, I think, you know, that's gotta be something that's on everybody's mind and related to that is HIPAA protection. So, you know, data breach is one thing that's that affects any, could affect any business, but HIPAA, which is, you know, another standard for us to abide by.

[00:12:38] Know, we have personal liability for HIPAA violations. And I think the government differentiates between those that are unintentional versus intentional. So can you talk a little bit about how that relates to data breach? It is a little bit different.

[00:12:53] alene: [00:12:53] Sure. And I would, I would encourage everyone, you know, it's, it's easier to just see the email from someone about the patient, but these really should be encrypted emails and sent securely because you could be at risk and putting yourself in your entire department or your entire office at risk for some significant, you know, it could be considered malpractice. You know, you don't want to even put yourself in that situation. So,  we're very fortunate that parents want to have dentists working together and collaborating. I just would recommend doing it the proper way and meeting all the standards. So you don't find yourself in any type of litigation concerns.

[00:13:39] Joel: [00:13:39] Yeah, that encryption is so critically important. And I think, uh, you said it, we have to, we have to have processes. We have to have systems in place. That's what all of this insurance is about is having the right protections and systems. I want to shift it towards the end of our conversation. Dr. A’lessio talk about specific policy types that would have impact. [00:14:00] Uh, in protecting us in certain instances. So we're still in the middle of this pandemic. It's getting better and we can see light at the end of the tunnel. But I remember a year ago when, when COVID hit, I was practicing the day we were shut down literally in the day before we all saw a lot of patients and then we didn't know what was coming.

[00:14:20] And then the conversation evolved into protecting our businesses and people were asking, do, do some of these insurances, they have. Some of the ones you described just a moment ago, do they protect us? And they cover us in situations like COVID. Is there any insurance that can protect you from COVID and I'm not terms about health and talking about the business.

[00:14:40] alene: [00:14:40] And unfortunately there's nothing that anyone could have done to cover something like COVID. So as far as the policy, no, there isn't. But if something had resulted from that meaning. Let's say you had to install these new, uh, filtration systems or new washer and dryers because they were wanting us to, wash the scrubs in between everything.

[00:15:12] And then there was a water leak. Those business owner policies can help protect, but as far as COVID and being shut down, no, unfortunately not. That's where more of the PPP payment protection program came in. To effect, but not necessarily, as far as an insurance policy, per se, it's such an unexpected, rare thing.

[00:15:35] Joel: I think we'll all be better prepared in other ways, but I think there was no way to get specifically reimbursed from COVID. But what about, you know, we are covered if there's a fire or loss of production over extended period, what kind of, what kind of policy would protect us from those things?

[00:15:49] alene: [00:15:49] That would be the, uh, business, um, overhead, um, or business owner policy. And then that's going to protect you from those fires. Um, just making sure the right insurance. And that's why I would have someone in this expert field, because even though there's. Life insurance disability. You know, there's so many different avenues in each of those that you can take, what type of claims that you want on each of those, you know, uh, what kind of limits?

[00:16:21] So the more protection you have, the more obviously you're gonna pay. So it depends on how much you are willing to risk versus, uh, how much you want to. Sleep a little more comfortably at night. It just depends on where you're at. And I think the people that do the insurance, they see it all. I love all these insurance commercials because they really do see it all.

[00:16:46] So they're gonna be able to advise you and tell you, okay, I would spend more on this. This is the risk benefit ratio. That's all we do as dentists on a daily basis. Okay. What's our risk benefit for this? So I think us as individuals have to see what is going to make us feel the best, but also listening to the experts in this field, knowing how to move forward.

[00:17:09] And what's going to be the best thing because. What works for me at a hospital is going to be completely different than someone out in a private practice. You know, you have to think about, you know, working with partners and workers' compensation. There's so many different avenues that you're going to have to think about in which area you go in.

[00:17:29] Are you going to be more in academics? You know? So I just encourage every resident to find someone that specializes in the insurance. And if your program doesn't have it, you can reach out to me and get someone to come in and talk to you guys, get two different groups to come in, so you can compare and figure out what's best for your certain situation.

[00:17:54] Joel: [00:17:54] Yeah, and you, you've given us a timeline and we're going to post that, uh, for those listening in the description of this and newly erupted website, take a look. And, Dr. Alessia has given us a timeline of insurances. You should consider it very stages in your life and your career. So going back to our residents who are starting their career, what,  definitely should somebody have in terms of insurance have had in the event, they actually get injured. God forbid, unfortunately, during their residency, I've, I've heard that I've know of that happening in many instances.

[00:18:27] alene: [00:18:27] Absolutely. So I would get that disability before you even start get it as a dental student. Start now, even if you might get a better rate, you can always renew it when you start your residency.

[00:18:41] Don't wait, because something, I have seen it way too many times with residents and then it's too late because you might get a policy, but there might then be a little asterisk saying, okay, well, here's this little clause in here that, uh, they have to prove that it'll cover them except. You don't want any exceptions on your policies.

[00:19:06] So I would get that while you're young and healthy, and they're going to, you're going to have to have someone come out. You know, it's going to be taking a health history, taking your cholesterol, doing some blood work. So it's, it's a minimal inconvenience for a lifelong, uh, Feeling comfortable because you guys have all worked so hard to do this.

[00:19:28] And I don't want to see anyone losing that. So disability would be number one on my list, right? When you're a resident, if not prior to residency,

[00:19:37] Joel: [00:19:37] I can tell Dr. Alessio you're a great mentor to many because you're giving great advice on people's personal lives, combined with their careers. And their clinical development. It's all good. So, any last words of advice to our future superstars in the profession?

[00:19:54] alene: [00:19:54] Yes, I would just say your biggest investment is investing in you and your family. So take care of yourself, stay healthy. Don't get too worried about this. Let the experts, let the experts do this so you can concentrate on what you know and what you love, but take care of yourself first, so you can take care of the patients, take care of your family and your loved ones. So you have to stay healthy yourself.

[00:20:24] Joel: [00:20:24] So as we hear, when we fly, we hear, uh, put your oxygen mask on first and then you can help others. Yep. Thank you so much for being with us today on newly erupted. Really appreciate it.

[00:20:36] alene: [00:20:36] Well, thanks so much, Dr. Berg, take care. Thank you all.