Podcasts about idr

In this episode of Journey to Launch, I'm joined once again by Travis Hornsby, founder of Student Loan Planner. Travis returns to break down the current state of student loans, including what's changed under the Biden and Trump administrations, what borrowers should expect moving forward, and how to navigate the uncertainty with smart, strategic planning. Whether you're a recent grad or have six-figure student debt, this episode will help you better understand your options and next steps. What You'll Learn in This Episode: What happened to Biden's student loan forgiveness and SAVE Plan—and why they're essentially dead How the IDR account adjustment and PSLF waiver may still benefit you What the new GOP proposals could mean for repayment plans and forgiveness timelines The difference between public vs. private student loans—and strategies for managing each Why many borrowers should consider enrolling in an Income-Driven Repayment (IDR) plan now Check out the video to this episode on YouTube here. Other Links Mentioned in episode:  Book Your Custom Student Loan Plan at Student Loan Planner, here. Join the Journey to Launch Book Club to dive deeper into financial freedom with guided discussions and resources here! Get your copy of my book: Your Journey To Financial Freedom! Join The Weekly Newsletter List to get updates, deals & more! Leave Your Journey To Financial Freedom a review! Get The Budget Bootcamp Check out my personal website here. Leave me a voicemail– Leave me a question on the Journey To Launch voicemail and have it answered on the podcast! YNAB –  Start managing your money and budgeting so that you can reach your financial dreams. Sign up for a free 34 days trial of YNAB, my go-to budgeting app by using my referral link. What stage of the financial journey are you on? Are you working on financial stability or work flexibility? Find out with this free assessment and get a curated list of the 10 next best episodes for you to listen to depending on your stage. Check it out here! Connect with Travis Hornsby: Website Instagram: @StudentLoanPlanner Twitter:@StudentLoanTrav Facebook:@StudentLoanPlan Connect with me: Instagram: @Journeytolaunch Twitter: @JourneyToLaunch Facebook: @Journey To Launch Join the Private Facebook Group Join the Waitlist for My FI Course Get The Free Jumpstart Guide

On this episode of The Wholesome Fertility Podcast, I am joined by Dr. Nirali Jain (eggspert_md), a board-certified OB/GYN and reproductive endocrinologist at Reproductive Medical Associates (RMA). Dr. Jain shares her expert insights on fertility preservation for individuals undergoing cancer treatment, a crucial yet often overlooked aspect of reproductive care. We explore what options are available for fertility preservation, including egg and sperm freezing, and why it's so important to initiate these discussions before starting chemotherapy or radiation. Dr. Jain also explains the difference between Letrozole and Clomid, the impact of estrogen-sensitive cancers on IVF treatments, and innovative approaches like random-start cycles and DuoStim protocols. Whether you're facing a cancer diagnosis or simply thinking proactively about your reproductive future, this conversation is filled with knowledge and reassurance. Key Takeaways: Why it's essential to discuss fertility before starting cancer treatment. The role of Letrozole in estrogen-sensitive cancers and fertility preservation. Differences between Letrozole and Clomid, and why Letrozole is often preferred. How new protocols like DuoStim and random-start cycles are improving outcomes. Why fertility preservation is important even for those without a cancer diagnosis. Guest Bio: Dr. Nirali Jain (@eggspert_md) is a board-certified OB/GYN and fertility specialist at Reproductive Medicine Associates (RMA) in Basking Ridge, New Jersey. She earned both her undergraduate degree in neurobiology (with a minor in dance!) and her medical degree from Northwestern University, before completing her residency at Weill Cornell/NYP, where she served as co-Chief Resident, and her fellowship in reproductive endocrinology and infertility at NYU Langone. Deeply passionate about women's health and fertility preservation, Dr. Jain blends the latest research and cutting-edge treatments with compassionate, patient-centered care. Her interests include third-party reproduction and oncofertility, and she is especially passionate about supporting patients navigating fertility preservation through a cancer diagnosis. Outside of the clinic, Dr. Jain is a trained dancer, a dedicated global traveler, and an adventurer working toward hiking all seven continents with her husband. Her diverse experiences, from international medical rotations to personal connections with friends and family navigating infertility, have shaped her into a warm, resourceful, and determined advocate for her patients. Links and Resources: Visit RMA websiteFollow Dr. Nirali Jain on Instagram For more information about Michelle, visit www.michelleoravitz.com To learn more about ancient wisdom and fertility, you can get Michelle's book at: https://www.michelleoravitz.com/thewayoffertility The Wholesome Fertility facebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/ Disclaimer: The information shared on this podcast is for educational and informational purposes only and is not intended as medical advice. Please consult with your healthcare provider before making any changes to your health or fertility care. --  Transcript:   # TWF-Jain-Nirali (Video) ​[00:00:00]  **Michelle Oravitz:** Welcome to the podcast Jain.  **Dr. Nirali Jain:** Thanks so much for having me **Michelle Oravitz:** Yeah, so. **Michelle Oravitz:** I'm very excited to talk about this topic, which, um, actually you don't really hear a lot of people talking about, which is how to preserve your fertility if you're going through a cancer diagnosis and if you have to go through treatments. 'cause obviously that can impact a lot on fertility. **Michelle Oravitz:** I have, um, seen actually like a colleague of mine go through. And she also preserved her fertility and, and now she has a baby boy. so it's really nice. **Michelle Oravitz:** to **riverside_nirali_jain_raw-video-cfr_michelle_oravitz's _0181:** so nice. **Michelle Oravitz:** So I'd love for you first to introduce yourself and kind Of give us a background on how you got into this work. **Dr. Nirali Jain:** Of course. Um, so I am Dr. Narly Jane. I am, um, an OB GYN by training, and then I did an additional, after completing four years of residency in OB GYN and getting board certified in that, I did an additional training in reproductive endocrinology and [00:01:00] infertility or otherwise known as REI. So now I'm a fertility specialist. **Dr. Nirali Jain:** Um, I trained at Northwestern in Chicago, so I went to undergrad and medical school there. And then, um, home has always been New Jersey for me, so I moved back out east to New Jersey. Um, I did all my training actually in New York City at Cornell for residency and NYU for fellowship. Um, and then moved to the suburbs. **Dr. Nirali Jain:** Um, and now I'm a fertility specialist in, in Basking Ridge at Reproductive Medical Associates.  **Michelle Oravitz:** Very impressive background. That's awesome.  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** I'd love to hear just really. About what your process is. If a person has been diagnosed with cancer, like what is the process? What are some of the things that you address if they are trying to preserve fertility, and what are some of the concerns going  **Dr. Nirali Jain:** yeah, yeah. All great questions. So, you know, there's a lot of us, uh, the Reis. Are a very small, [00:02:00] there's a very small number of us. So in terms of specializing in fertility preservation, technically we all are certified to treat patients with cancer and kind of move them through fertility preservation before starting chemotherapy. **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** Um, luckily we've been working closely with oncologists in the past several years just to establish some type of streamlined system because having a diagnosis of cancer and hearing all that information. Especially when you're young is so hard. So I think that's, that's where my interest started in terms of being able to speak to and counsel cancer patients. **Dr. Nirali Jain:** I think it is a very specific niche that you really have to be comfortable with in our field. Um, I. So I'll kind of walk you through, you know, what it, what does it look like, right? Um, you go into your oncologist's office suspecting that you have this, this lump. I'll take breast cancer, for example. It could really be any kind of cancer. **Dr. Nirali Jain:** Um, but breast cancer in a reproductive age patient or someone that's in those years where you're starting [00:03:00] to think about building a family, planning a family, um, or if you have kids at home, that's usually the type of patient that we see come in with a breast cancer diagnosis. So. Kinda just taking that, for example, um, the minute that you're diagnosed, it's really your oncologist's responsibility to counsel you on what treatment options are going to be offered to you. **Dr. Nirali Jain:** And then based off of the treatment options, it's important to know how that affects your reproduction. So how does it affect your ovaries in the short term, in the long term, um, in any way possible. So. Once a patient is initially referred from their oncologist to myself or any other fertility specialist, they come into my office and we just have a 30 minute conversation really talking about family planning goals. **Dr. Nirali Jain:** Any kids that they've had in the past either naturally conceived or through um, IVF, and then we talk about where they're at in their relationship. Are they married, are they not? Are they with a partner, [00:04:00] a male partner, a female partner, whatever it might be. It's important to know the social standpoint, um, especially in this sensitive phase of life. **Dr. Nirali Jain:** So patient patients usually spend anywhere from 30 minutes to an hour. Um, just kind of talking through where they're at, how they're feeling, what their ultimate childbearing goals are. And then from there we do an ultrasound and that's when I'm really able to see, you know, the, the reproductive status. **Dr. Nirali Jain:** So what do the ovaries look like? What does the uterus look like? Is there something that I need to be concerned about from a baseline GYN standpoint? Um, and all of those conversations are happening in real time. So. I think one of the things is patients come in and they're like, I'm already so overwhelmed with all this information from my oncologist, and now my fertility specialist is throwing all this information at me. **Dr. Nirali Jain:** Luckily, the way I like to frame it is you come in and you just let go. Like you let us do the work because in the background we're the ones talking to your oncologist. We're the [00:05:00] ones giving that feedback and creating a timeline with your oncologist. Um, and really I think just getting in the door is the hardest part. **Dr. Nirali Jain:** So once patients are here to see us, we go through the whole workup. We do anything that we would do for a normal patient that came in for fertility preservation. And then based off of where they're at in their journey, we talk about what makes sense for them, whether that means freezing embryos, freezing eggs, they're very similar in terms of the, the few weeks leading up to the egg retrievals. **Dr. Nirali Jain:** So I have that whole conversation just at the initial visit. And then from there we talk about the timeline behind the scenes and make sure that it works with their lives before moving forward. **Michelle Oravitz:** So for people listening to this, why, and this might be an obvious question, but to some it might not be,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** why would somebody want to preserve. eggs or sperm. 'cause I've had actually some couples  **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** come to me where the husband preserved the sperm and they had to go through IVF just because he was going [00:06:00] through cancer treatments. So he had to preserve the sperm ahead of time.  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** people need to consider doing that before doing cancer treatments?  **Dr. Nirali Jain:** So there are certain cancer treatments that do affect the ovaries and the sperm health, and you know, for men and women, it affects your reproductive organs. In a similar way, um, depending on the type of chemotherapeutic agent, there are some that are more dangerous in terms of, um, being toxic to your ovaries or toxic to your sperm. **Dr. Nirali Jain:** And those are the instances where we are really thinking about what's the long-term impact because there's medications that oncologists do give patients, and our oncologists are amazing, the ones that we work with, Memorial Sloan Kettering from Reproductive Medical Associates through RMA, um, and. **Dr. Nirali Jain:** They're just so good at what they do and are so well-trained, so they know in the back of their mind, is this going to impact your ovaries or your sperm health or not? Um, and I [00:07:00] think that any chemotherapy, you know, your ovaries are these, these small organs that are constantly turning over follicles every month. **Dr. Nirali Jain:** So every month we're losing those eggs, and if they don't become. If an egg isn't ovulated, it doesn't become a baby, it's just gonna die off. So I counsel even patients that don't have cancer, I counsel them on fertility preservation as young as possible. You know, between the ages of 28 and 35, that's like the best time to preserve your fertility. **Dr. Nirali Jain:** So in cancer patients, there's an extra level added to that where even if they are a little bit younger, a little bit older. Your eggs are not gonna be the same quality. There's gonna be higher level of chromosomal errors, more DNA breakage, um, and, and bigger issues that lead to issues with conceiving naturally afterwards. **Dr. Nirali Jain:** So I think that it's important to consider how that chemotherapy is going to affect them or how surgery would affect them if it was, for example, a GYN cancer where [00:08:00] we're removing a whole ovary, you know, what, what do we have to do to preserve your fertility in that case? And those are important conversations to have. **Michelle Oravitz:** Yeah. for sure. I know that a lot of people are also concerned, you know, with going through the IVF process, you're taking in a lot of estrogen, a lot of hormones, and many cancers are actually estrogen sensitive. So I wanted to talk to you about that. 'cause I know that the data shows that it's. It's been fine, which some people might find surprising, but I wanted you to address that and just kind of **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** from your perspective.  **Dr. Nirali Jain:** That's so interesting that you asked that question because I actually, my whole I I graduated fellowship last year and my entire, like passion project in fellowship was looking at one of the drugs that we use to suppress the estrogen levels specifically in cancer patients. Um, and I had presented this at a few of our reproductive meetings. **Dr. Nirali Jain:** Um, A SRM is one of our annual meetings where all of the reiss get together. A lot of male fertility [00:09:00] specialists come and we kinda just talk about. Specific things and fertility preservation for cancer patients is, has been an ongoing topic of interest for all of us. Um, and it's important to know that there are different medications that we can offer. **Dr. Nirali Jain:** Letrozole is the one that I, um, have a particular love for and I, uh, you know, I use all the time for my patients, um, for different reasons, but it suppresses the exposure that your body has to estrogen. And there's mixed data, um, out there in terms of, you know, does Letrozole suppression actually impact, you know, does it help or. **Dr. Nirali Jain:** Or does it have no impact on your future risk of cancer after treatment? Um, and that honestly is still up for debate. But what we do know is that there's no increased risk of cancer recurrence in patients that have undergone fertility preservation with or without Letrozole. Um, Letrozole is one of those things that we can give, and the way it works is basically. **Dr. Nirali Jain:** It masks that [00:10:00] conversion. It, it doesn't allow for conversion from those androgens in the male hormones over to estrogen. Um, and so your body doesn't really see that estrogen exposure. It stays nice and low throughout your cycle, and it does help with actually ovarian maturation and getting mature eggs harvested and, um, helps a little bit with, with quality too. **Dr. Nirali Jain:** So I think that it's really nice in terms of having that available to us, but know that. It's not, it's not essential that you have it, really, the data showing plus minus. Um, but there are certain things that we can do to protect the ovaries, protect your exposure to estrogen. Um, and so that shouldn't be top of mind of concern when we're going through fertility preservation, even with an estrogen sensitive cancer. **Michelle Oravitz:** Actually, so, uh, on a different topic, kind of going back to that, so Letrozole versus Clomid, I, it's like a, the questions I personally feel just based on what I've heard and like my own research that Letrozole would be kind of like the more. [00:11:00] Um, the, it's, it's a little better, but I know that it really depends on the person as well.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** they might do better with Clom, but I'd love to hear your perspective and kind of pick your brain on this.  **Dr. Nirali Jain:** totally. You're choosing all the, all the right questions because these are all of my, my specific interests and niches. So  **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** Letrozole is basically, you know, we use Letrozole and Clomid in. Patients that don't have cancer and patients that come in for an intrauterine insemination, that's kind of the most common scenario where we're thinking about, you know, which medication is better? **Dr. Nirali Jain:** Letrozole or Clomid and Clomid used to be the, the most common medication that we use, we dose patients, you know, have 50 milligrams of Clomid, give them five days of the medication. It's an oral pill. Feels really easy and. The way it works is really, it recruits more than one follicle, so it really helps with the release of, um, more than one follicle growing more than one follicle in the ovary. **Dr. Nirali Jain:** Um, but it has a little bit [00:12:00] higher of a risk of twins because that's exactly what it's good at. Um, Clomid, not so much in the cancer. In the cancer front, it's not really used there because it's considered, from a scientific perspective, it's considered like a selective estrogen receptor modulator. So it doesn't necessarily suppress your estrogen levels in the same way that Letrozole does versus. **Dr. Nirali Jain:** Letrozole is an aromatase inhibitor, so it really blocks the chemical conversion of one drug or one hormone to the other hormone. Um, the reason we love Letrozole so much, and I don't mean to like gush over Letrozole, but um, it's a mono follicular agent, so it works really well at recruiting one follicle  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** you know, every OB-GYN's nightmare in a way is having multiples when you didn't intend on having multiples at all. **Michelle Oravitz:** so  **Dr. Nirali Jain:** Um. **Michelle Oravitz:** were saying that, um, there's more of a chance of twins, it's Clomid, not letrozole.  **Dr. Nirali Jain:** Yes, there's a higher chance with Clomid versus Letrozole. And I mean, don't get me wrong, there's a chance of twins with [00:13:00] any type of assisted reproductive technology. Even when we're doing single embryo transfers, there's a chance that it's gonna split. So, um, the chance is always there just like it is in the natural world. **Dr. Nirali Jain:** But we know for a fact that. CLO is really good at recruiting many follicles. It's good for certain patients that don't respond well to Letrozole. Um, but Letrozole is kind of our, our go-to drug these days just because of all the benefits that we've seen.  **Michelle Oravitz:** Awesome.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** These are all fun things to ask because I, I love talking to our eis 'cause there's so much information that I'm always  **Dr. Nirali Jain:** totally. **Michelle Oravitz:** learn a lot from my patients in my own research, but it's really cool. Picking your guys' brains. So another question I have, and I have actually talked to Dr. Andrea Elli, he's been on,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** and he does a lot of endometriosis and, and immune related work as well,  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** so. I'd love to know just from your perspective. One thing that I do know from, based on what I've heard is that the, [00:14:00] guess like you were just saying, that breast cancer or estrogen sensitive breast cancer doesn't seem to be affected by IVF cycles, however, and endometriosis lesions do get affected.  **Dr. Nirali Jain:** Yeah. **Dr. Nirali Jain:** that's a great question. So, you know, every, there are so many complex G mind diagnoses that the, that our patients come in with. Um, and endometriosis is a big one because there is clear data that endometriosis is linked to infertility. So we think about, you know, when a patient comes in with endometriosis, we really do think about the different treatment options and what are the short-term and long-term impacts of the hormones that we're giving 'em. **Dr. Nirali Jain:** Um, these days, again, kind of going back to Letrozole, we, letrozole is something that I give all of my endometriosis patients because it helps suppress their estrogen because we know.  **Michelle Oravitz:** interesting.  **Dr. Nirali Jain:** is very responsive to estrogen and leads to this dysfunctional regulation of all the endometrial tissue that can really flare in a, [00:15:00] in a cycle, or shortly after a cycle. **Dr. Nirali Jain:** I. So we really, for endometriosis patients, the, the best treatment is being on birth control because we don't see that hormonal fluctuation. The up and down of the estrogen and the progesterone, that's what leads to those flares. Um, so I really, I watch patients closely after their cycles too, because you definitely can have an endometriosis flare and we say the best treatment for endometriosis is pregnancy, right? **Dr. Nirali Jain:** That's when you're suppressed, that's when you're at your lowest. Um, and patients, my endo patients feel so good in pregnancy because they have. Hormones that are nice in that baseline, they're not getting periods of course. Um, and that's truly, truly the best treatment.  **Michelle Oravitz:** That's interesting.  **Dr. Nirali Jain:** But it is important to consider when you're going through infertility treatments. **Dr. Nirali Jain:** How does my endometriosis affect the short and long-term effects of the fertility medications? And really not to, not to say that they're bad in any way. I think a lot of endometriosis patients go through IVF and have success and do really, really well, and that's kind of the push that they need. [00:16:00] Um, but it's important to be mindful of the bigger picture here. **Dr. Nirali Jain:** It's not just, you're not just a number of. A patient with endo coming in, getting the same protocol. It's really individualized to the extent of your lesions, what symptoms you're having, what grade of endometriosis, where your lesions are. So we're the RAs are thinking about everything before we actually start your protocol. **Michelle Oravitz:** It's crazy how in depth it is, and it's, it, there's just so, it's so multifaceted,  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** when it's females  **Dr. Nirali Jain:** totally. **Michelle Oravitz:** are a little, I mean, they can, you know, there, there's definitely a number of things, but it's not as complicated and interconnected  **Dr. Nirali Jain:** Exactly. Exactly. That's so true. **Michelle Oravitz:** And so one question I actually have, this is kind of really off topic, but something that I was curious about. **Michelle Oravitz:** 'cause I heard about a while  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** a, a type of cancer treatment that was used. I'm not sure exactly what it was, but for some reason it actually caused follicles to grow, [00:17:00] or to multiply. And they were **Dr. Nirali Jain:** Interesting. **Michelle Oravitz:** this definitely. Puts, um, the whole idea of like a woman being born with all the follicles she'll ever have on its head, I thought that was really Interesting. **Michelle Oravitz:** Now I learned a little bit about it. I don't think it really went further than that,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** one of those things that they're like, Hmm, this is interesting. I don't know, it was kind of a random side effect of this chemo drug. I dunno if it was a chemo drug or a cancer drug.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** ever heard of that. **Michelle Oravitz:** So I was just **Dr. Nirali Jain:** I haven't, I mean, that's interesting. I feel like I'd have to look into that because that would be definitely a point of interest for a lot of Reis. But it kind of does go back to the point of, you know, women are really born with all the eggs we're ever gonna have. So it's about a million, and then it just goes down from there. **Dr. Nirali Jain:** And the, by the time you start having periods, I like to kind of show my patients a chart, but you have a couple hundred thousand eggs and you ovulate one egg a month. That's, you know. Able to [00:18:00] progress into a fertilized egg and then into a, an embryo into a baby, um, if that's your goal. But otherwise, patients that are having periods and not trying to actually get pregnant, we're losing hundreds of eggs a month. **Dr. Nirali Jain:** So.  **Michelle Oravitz:** Mm.  **Dr. Nirali Jain:** It's important to kind of think about that decline, and it's important to know that that rate can be faster in patients with cancer, patients with low ovarian reserve. And sometimes when you have the two compounded, that's when a fertility specialist is definitely, you know, in the queue to, to have a discussion with you in terms of what that means and how you can reach your family building goals despite being faced with that, with that challenge. **Michelle Oravitz:** Yeah. **Michelle Oravitz:** I mean, 'cause we know oxidative stress is one of the things that can cause, uh,  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** quality eggs, but it's also can cause cancer. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** um, similar, you know, like things that really deplete the body could definitely impact. Um, and then what are your thoughts? I know I'm asking you all kinds of random questions, **Dr. Nirali Jain:** I love it. **Michelle Oravitz:** are your thoughts about doing low simulation in certain [00:19:00] circumstances versus high stem? **Michelle Oravitz:** Sometimes people don't respond as well to higher stems.  **Dr. Nirali Jain:** Yeah, that's a great point. I think that it kind of all goes back to creating an individualized protocol. If. A patient's going to a practice and basically just getting a protocol saying, this is our standard. We start with our standard of, you know, I, I think about the standard, which is 300 of the FSH or that pen that you dial up, and then 150 units of that powder vial. **Dr. Nirali Jain:** And we have patients mixing powders all the time, and that's kind of our blanket protocol that we give patients. But that's not really what's happening behind the scenes. And if you're given a protocol that's, and being told, you know, this is kind of what we give to everyone, it's probably not the right fit for you. **Michelle Oravitz:** Yeah, I  **Dr. Nirali Jain:** Um, there are certain patients that respond to a much lower dose and do really, really well, and then some patients that need a much higher dose. Um, and I think it's, that's kind of like the fun part of being an REI of being able to individualize the [00:20:00] protocol to the patient. Um, and I know for a fact there are so many, luckily, you know, we have so many leaders in REI that have been. **Dr. Nirali Jain:** Have dedicated their entire careers to researching these different protocols and how they can help different patients. Um, patients with lower a MH, you know, might benefit from a duo stim protocol, for example. That's kind of the first one that comes to mind, but a protocol where we're using those follicles from the second half of a cycle. **Dr. Nirali Jain:** I would've never thought that those were the follicles that  **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** would be better than the first half of the cycle,  **Michelle Oravitz:** Wait,  **Dr. Nirali Jain:** but, **Michelle Oravitz:** that. Explain that. Um, because I think that that's kind of a unique  **Dr. Nirali Jain:** mm-hmm.  **Michelle Oravitz:** that I haven't heard of.  **Dr. Nirali Jain:** Yeah, so there's this new day. It's still kind of developing, but um, kind of going back to, you know, what's an individualized protocol? Duo STEM is one of the newer protocols that we've started using. I, I've used it once or twice in patients. Um, but it goes back to the research that shows that you might actually have two different periods of time in a menstrual cycle where you could potentially recruit [00:21:00] follicles. **Dr. Nirali Jain:** You could have a follicular phase where there's a certain cohort of follicles recruited, and then you have a follicle that forms creates a corpus glut.  **Michelle Oravitz:** um, protocols  **Dr. Nirali Jain:** Yep. And then you basically go through the follicular protocol and then a few days after a retrieval, instead of waiting for a new follicular cohort or follicular recruitment from the first half of your menstrual cycle, you actually use the luteal phase and you recruit those follicles that would've actually died off or have been prematurely recruited in a prior cycle. **Dr. Nirali Jain:** So **Michelle Oravitz:** that's So  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** you just do a similar, I guess, um, medicine,  **Dr. Nirali Jain:** go right back into it.  **Michelle Oravitz:** do the same exact thing, but right after ovulation.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** Fascinating. That's really interesting.  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** has been your experience with that?  **Dr. Nirali Jain:** I think it's, honestly, it's mixed. Um, so far, you know, our data from fertility and sterility and A SRM, it, it shows support for these DUO STEM [00:22:00] protocols, saying that if patients don't have that great quality of eggs or if they have a very low number, maybe they'd benefit from starting the meds earlier and recruiting follicles. **Dr. Nirali Jain:** A little bit earlier. Um, so we've seen positive results so far. A lot of work to be done in terms of really understanding it. Um, and of course, as a new attending, I have a lot more experience to kind of build on. Um, but I, I have seen success from it. **Michelle Oravitz:** That's fascinating. Are there any other new technologies, like new add-ons, um, that you've seen, that you've found to be really cool or interesting?  **Dr. Nirali Jain:** I think the biggest thing, actually, kind of going back to our whole topic for today is fertility preservation cancer patients. One of the biggest things that I've learned recently is that we used to start fertility, um, patients. You know, only in the beginning of the cycle days, two or three is technically like when most. **Dr. Nirali Jain:** Most clinics, um, start patients, but for our cancer patients, sometimes you don't have that time. You don't wanna wait a full month to [00:23:00] restart, um, your, you know, your menstrual cycle and then do the fertility preservation and then delay chemotherapy a full month. So we started doing what we call random starts. **Dr. Nirali Jain:** So you basically start a patient whenever they come in. You know, it could be the day after your consultation, the day of your consultation. I've kind of seen all of the above. Um, and we've seen really good success with random starts, per se. Um, and we've been doing a lot more of that, where it's not as dependent on where you're at in your cycle. **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** Um, obviously there's a difference in outcomes. You might not be a great candidate for it, so definitely it's worth talking to your doctor about it. But it kind of gives relief to our cancer patients where if you have a new cancer diagnosis and you're like, oh, I just finished my period, like, I can't even start a cycle until next month. **Dr. Nirali Jain:** That's not always true. Um, so it's always worth it to go into see a fertility specialist and just get, you know, get the data that you need right away, and then you can make a decision later on. **Michelle Oravitz:** For sure. Um, Yeah. **Michelle Oravitz:** and I wanted to kind of cover a lot of different topics 'cause I know that [00:24:00] some people are gonna wanna hear what you have to say that don't necessarily, or, uh, have cancer. But it is important. I, I think that, you know, if you get to thirties and you haven't gotten married or you don't have a partner, I think it's really important to preserve your fertility in general.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** important thing. And then if you were going through a cancer diagnosis and you decided to preserve your fertility, um, guess more for women because they're eventually going to be thinking about transfers after they go through treatment. So what are some of the things that they would need to consider as far as that goes? **Michelle Oravitz:** Like after the  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** then they go through the cancer treatments. Um, and then what, how long should they  **Dr. Nirali Jain:** yeah. Like what does it look like? So I've had patients that come back, you know, in my fellowship training I did a, a couple research projects on patients that came back to pursue an embryo transfer, um, after chemotherapy agent. And basically compared them to how they did, um, [00:25:00] compared to patients that didn't have cancer and just froze their embryos or froze their eggs and then came back to pursue a transfer and. **Dr. Nirali Jain:** I think the, the most reassuring thing from the preliminary data that we have is saying that there's no difference in pregnancy rates and no difference in life birth,  **Michelle Oravitz:** Awesome.  **Dr. Nirali Jain:** of whether they had chemotherapy or not. After freezing those eggs and going through fertility preservation.  **Michelle Oravitz:** Amazing.  **Dr. Nirali Jain:** Um, in terms of where your body needs to be, I think the oncologist, we, we wait for their green light. **Dr. Nirali Jain:** We wait for their signal to say, you know, she's safe to carry a pregnancy.  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** And then once we do that, we basically treat you like any other patient. So if you're coming in for a cycle, if you're having periods, then it's reasonable to try a natural cycle protocol, wait for your body to naturally ovulate an egg. **Dr. Nirali Jain:** And instead of obviously hoping that egg will fertilize, we, um, use a corpus luteum. We use the progesterone from the corpus luteum to really support this embryo being implanted into the uterus. Um. Yeah. [00:26:00] And then there's also another side. I mean, some patients don't get their periods back and they always ask like, what if I never get my period back? **Dr. Nirali Jain:** What if I'm just like in menopause because of the chemotherapy agents? And for that, we can start you on a synthetic protocol or basically an estrogen dependent protocol where you take an estrogen pill for a certain number of days. We monitor your lining, then we start progesterone, um, to support your hormones from that perspective instead of relying on your ovaries to release the progesterone that they need, um, and then doing the embryo transfer a few, few days after progesterone starts. **Dr. Nirali Jain:** So there's definitely different protocols depending on where your menstrual health is at after the chemotherapy or after the cancer treatment. Um, but it's important to kind of just know that. That there's options. It doesn't mean that it's the end of the road if you all of a sudden stop getting your period. **Michelle Oravitz:** Yeah, for sure. I mean, 'cause you, technically speaking, you can really control a lot of that. More so for transfers  **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** Retrievals really is kind of like what [00:27:00] eggs you have, what the quality is. But people can be in complete menopause and you guys can still control their cycles for transfer, which is kind of. A huge difference  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** in the  **Dr. Nirali Jain:** exactly. That's exactly right. Yeah. **Michelle Oravitz:** interesting. Any other, um, new, new things that you're, you guys are excited about? I always like to hear about like the new and upcoming things  **Dr. Nirali Jain:** Of course.  **Michelle Oravitz:** actually before, which I thought was fascinating. Yeah.  **Dr. Nirali Jain:** I feel like there's always like updates and, and new data and things like that coming out, but just know, I think it's important for patients to know, like we're constantly, we're, the reason I chose to even pursue this field was because it's new. Right. There's something that we are discovering every day, every year, and that's what makes our, our conferences so important to attend, um, to really just stay up to date. **Dr. Nirali Jain:** Um, but we are, uh, constantly updating our embryology standards, the way we thaw our eggs, and the success rate associated with a thaw and [00:28:00] how we treat our embryos and the media that we use, right? Like, so we're really thinking about the basic science perspective every single day, and that's what makes this field so unique. **Michelle Oravitz:** It is really awesome. And so do you guys specialize specifically on, um. Egg freezing and, and I mean specific fertility preservation in patients that do that have cancer that are going through treatments, do you guys specialize specifically in that? I mean, I know you do range  **Dr. Nirali Jain:** Yeah. Yeah, because it's such a small community, we all have our own niches and we all kind of have our own interests and  **Michelle Oravitz:** Yeah.  **Dr. Nirali Jain:** no like specific training. There are a couple courses that you take that I took in in training as well, just to kind of understand what it sounds like to, I. Council of fertility preservation, patient with and without cancer. **Dr. Nirali Jain:** Um, and then, you know, you kind of just learn by experience and you form a niche for something that you're passionate about. 'cause that's what makes you, you know, really thorough in, in your treatment. [00:29:00] So that's one of my interests. Um, and, but I would say,  **Michelle Oravitz:** training for that. It's just like  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** just know how to treat that in  **Dr. Nirali Jain:** exactly.  **Michelle Oravitz:** especially if you're interested in doing that.  **Dr. Nirali Jain:** Exactly. That's exactly right. It's kind of, it just comes with the experience comes with your mentors and who you're surrounded by, and everyone kind of helps each other get to that point. But there are several specialists in our practice at RMA that specialize specifically in fertility preservation in cancer patients. **Dr. Nirali Jain:** So we have a close communication with our oncologist and they know who to refer to within the practice because everyone has their own little interests.  **Michelle Oravitz:** Amazing.  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** Um, definitely. I, like I said, I really enjoy picking your brain because it's a lot of fun for me. I, I do  **Dr. Nirali Jain:** Totally.  **Michelle Oravitz:** acupuncture, so  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** and I, I think that it's just so crazy that our fields don't work together. I mean, we kind of do, but I think, I just feel like it would be so great  **Dr. Nirali Jain:** exactly.[00:30:00]  **Michelle Oravitz:** the expertise because you guys have immense. Benefits like in, in, uh, technology and incredible innovations and, and then the natural aspect of really understanding the, the body. And I, I just think that it would work so amazing together if it was more of like a thing. 'cause it, I know in China they actually combine the two  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** eastern.  **Dr. Nirali Jain:** Yeah, I mean I think that that's so important and there is data that shows, you know, there's actually a recent study that came out just a few weeks ago on the benefits of acupuncture for fertility patients. And we know that, I mean, I recommend it to all of my patients, specifically the day of the embryo transfer. **Dr. Nirali Jain:** We, luckily, we offer it on site at RMA and we have acupuncturists that come in and, and do a session before and after the embryo transfer, and I think. A lot of that is targeted towards stress relief. But I also think that holistically it's important to feel at your best when we're doing something that's so crucial to your, to your health. **Dr. Nirali Jain:** So to really focus on the diet, focus on stress relief, [00:31:00] focus on meditation, yoga, whatever it takes to get to your best wellbeing when you're going through fertility treatments, um, is so important. So I appreciate  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** like you that really specialize in the other side of. Of this, because I do consider it still part of the holistic medicine that we need to really maximize success for our patients. **Michelle Oravitz:** Awesome. Well,  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** Jane, this is such a pleasure Of talking to you. You've given us some, so much great information and we've definitely dived into a, do a topic that I don't typically, I haven't yet spoken about. But, um, that being said, it's such an important topic to talk about. And thank you so much for coming on today. **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** course. **Michelle Oravitz:** I get off, how can people find you?  **Dr. Nirali Jain:** That's a great question. So I have, um, a social media page. I, it's called Expert nc. So like EGG,  **Michelle Oravitz:** I  **Dr. Nirali Jain:** um, expert nc. Try, tried to make it a little bit humorous. Um, but I'm all over social [00:32:00] media and would love to hear from anyone that is listening. I, you know, every, every day I get different, um, dms and I'm happy to respond. **Dr. Nirali Jain:** I love hearing about everyone else's. Stories and things like that. Um, so that is kind of my main, main social media platform. Um, and then through like RMA and Reproductive Medical Associates, we also have a YouTube channel. We have an Instagram page, um, of our office available, um, as well that is public. **Dr. Nirali Jain:** So you can find us pretty easily if you just kind of hit Google. But um, yeah, I'm kind of developing my social media platform as the expert and I hope it grows.  **Michelle Oravitz:** Love it. Great.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** was such a pleasure talking to you. Thank you. so much **Dr. Nirali Jain:** Thank you. **Michelle Oravitz:** today.  **Dr. Nirali Jain:** Of course. Thank you so much for having me.  [00:33:00]   

In this episode I'm excited to introduce you to Dr. Shilpa Sayana. She is Board Certified in both Internal Medicine and Functional Medicine and practices in the Los Angeles area. As a menopause expert, Dr. Sayana helps women through perimenopause, menopause, and post-menopause, focusing on hormone replacement and both symptom management and prevention of health issues throughout a woman's lifetime. Over 1 million women become menopausal every year in the U.S. I – Dr. Doni – am so grateful to have been trained in how to support women through menopause using natural approaches and bio-identical hormones when I was in naturopathic medical school at Bastyr in the 1990s. I've been helping women for over 25 years. And I'm so glad more medical doctors, like Dr. Shilpa, are becoming open to natural approaches, and trained in how to support women. We're here to help! LINKS FROM THE EPISODE:   Join Dr. Doni's “Say Goodbye To HPV” Program: https://hpv.doctordoni.com/hpv/checkout-12week-program    Connect with Dr. Shilpa: https://www.sayanamedical.com/    Menopause Program with Dr. Doni: https://dv296.infusionsoft.com/app/orderForms/Menopause    Sign up For Dr. Doni's Masterclasses: https://doctordoni.com/masterclasses/    Schedule A Chat With Dr. Doni: https://intakeq.com/new/hhsnib/vuaovx    Read the full episode notes and find more information: https://doctordoni.com/blog/podcasts/ MORE RESOURCES FROM DR. DONI:   Quick links to social media, free guides and programs, and more: https://doctordoni.com/links     Disclosure: Some of the links in this post are product links and affiliate links and if you go through them to make a purchase I will earn a commission at no cost to you. Keep in mind that I link these companies and their products because of their quality and not because of the commission I receive from your purchases. The decision is yours, and whether or not you decide to buy something is completely up to you.

Bramming Gymnastik- og Idrætsefterskole går meget højt op i at samle penge ind til fordel for Børnelungefonden Vi fik en snak med Sidsel Gadeberg. lærer på Bramming Gymnastik- og Idrætsefterskole, om hvor meget de har indsamlet.

Have you been paying your Student Loans? Have you been waiting on forgiveness of your Student Loans? Recently, the Department of Education has begun collection efforts for Student Loan borrowers behind on their payments, who have not repaid their debts or entered into some type of workout plan regarding their Student Loan debts. The government estimates that there are 6.4 million Student Loan borrowers between the ages of 50 - 60, that owe a combined $282 Billion - or $46,000 per borrower. For some history or background, Student Loan payments paused during the COVID pandemic. But in October 2023, Student Loan payments resumed (subject to any workout plan negotiated with the Department of Education).  Now, the government is seeking collection against any defaulted Student Loans, and they have as tools, the authority, under certain circumstances, to: (1) garnish wages, (2) intercept and retain tax refunds, and (3) intercept and retain social security payments. Unfortunately, Student Loans are still largely non-dischargeable under Bankruptcy Law, although there have been some in-roads. So how can you manage?  There are still options available, including: Income-Driven Repayment. Public Service Loan Forgiveness (PSLF) Modification You can also plan ahead for the costs of Education, by researching the different borrowing programs, Grants, 529 (and similar) plans. Let us know if you enjoy this episode and, if so, please share it with your friends! Please also visit our sponsor, Sam Cohen of Attorneys First Insurance for Attorneys and Title Companies looking to get a quote on Errors & Ommissions (malpractice) Insurance coverage. www.AttorneysFirst.com.   Or, you can support the show by visiting our Patreon page: https://www.patreon.com/crushingDebt   To contact George Curbelo, you can email him at GCFinancialCoach21@gmail.com or follow his Tiktok channel - https://www.tiktok.com/@curbelofinancialcoach   To contact Shawn Yesner, you can email him at Shawn@Yesnerlaw.com or visit www.YesnerLaw.com.  And although the 2025 Purple Stride Walk is over, please consider a donation to Pancreatic Cancer research and education by joining Shawn's 2025 Team at MY Legacy Striders: http://support.pancan.org/goto/MYLegacy8  The link will be available until June 30.

In this episode, we unpack the Supreme Court's unanimous decision in Cunningham v. Cornell University — a landmark ERISA case with major implications for retirement and health plan fiduciaries. We explain the facts behind the case, what “prohibited transactions” really mean, and why the Court's ruling on affirmative defenses matters. If your health plan pays fees to TPAs, PBMs, IDR vendors, or brokers, this episode is for you.

Got student loan questions weighing on you? You're definitely not alone. This week, we're opening up the Student Loan Planner mailbag to tackle some of the most pressing issues borrowers are facing. Should you switch IDR plans? Is Public Service Loan Forgiveness (PSLF) buyback the right move? We also address the very real frustrations with federal loan servicers — the long hold times, the inconsistent information, and the impact of staffing shortages. Beyond that, we'll cover practical tax filing strategies that could lead to significant savings, how to identify potential calculation errors in your loan details, and offer an update on the ongoing delays with forgiveness applications. If you're ready for clarity on your student loans, this episode delivers the answers you need in 2025. Key moments: (04:37) Stressing about interest accrual could be counterproductive on your path to loan forgiveness (07:45)  The PSLF buyback steps, and remember your qualifying payments don't need to be consecutive (16:53) Despite common talk of "old" and "new" IBR, there is technically only one Income-Based Repayment plan (26:07) A payoff strategy for a high-income physician facing loans without PSLF (43:33) Military families face unique PSLF considerations, with state residency affecting community property rules Links mentioned:  Income-Driven Repayment (IDR) Plan Request PSLF Help Tool Compare refinancing lenders   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

This episode is hot off the press! Today I saw an update from the Monash university about the changes to the classification of FODMAP foods and I'm bringing it straight to you! As a nutritional therapist working with people who have IBS I help people with FODMAP reintroduction so I need to stay up to date with any changes, and I'm bringing them to you, lovely listeners. This week I'll explore WHY FODMAP ratings can change, what it means for you, and which specific foods have been reclassified. LinksEp 28 - Fructose and how it affects your digestionEp 17 & 18 - introduction to the low FODMAP diet. **WIN** a free consult with me - give me feedback on my podcast here and enter into a prize draw to win a call with me - https://forms.gle/xChYCzyYEvtVcTNp6 Links from today's sessionBuy my Ultimate Guide to the Low FODMAP Diet - https://www.goodnessme-nutrition.com/ultimate-low-fodmap-diet-guide-find-your-ibs-triggers/2022 research Existing differences between available lists of FODMAP-containing foods https://www.reed.es/ArticuloFicha.aspx?id=6609&hst=0&idR=122&tp=1 Monash university - why do FODMAPs change - https://www.monashfodmap.com/blog/retested-foods-why-fodmap-content-might-change/ Work with me3 month Gut Reset - https://www.goodnessme-nutrition.com/consultations/Book a discovery call about working with me - https://calendly.com/annamapson/30min Ready for your gut reset?

What's coming for student loans over the next 3.5 years? There is a lot more than you've been told. Are there actually going to be changes? In this live stream, we're unpacking everything: ✅ The shift from the Department of Education to the SBA ✅ Proposed changes to IBR and the future of IDR plans ✅ The risk of PSLF disappearing as non-profit status comes under fire Are these real threats or just headlines. Whether you're chasing forgiveness, aggressively paying off debt, or somewhere in between… the next few years will separate those who plan from those who panic. We'll also cover: – What these changes really mean for new grads and borrowers – How to avoid the blind spots that trip up most borrowers – The steps you can take today to adapt before it's too late Oh and by the way, I also touch on tariffs....

ØB, Østerbro Boldklub, var en af de mange fælledklubber, der havde en meget tæt tilknytning til Københavns Idrætspark. Dels havde klublokaler og omklædningsrum i Idrætsparken, og dels spillede de ca. 250 kampe derinde, hvilket kun overgås af de fem store københavnerklubber, KB, B.93, AB, Frem og B1903.Podcastvært Torkil Fosdal fortæller om nogle af ØB's største kampe i Idrætsparken - og gennemgår i korte træk klubbens lidt over 100 år lange historie, der svingede mellem topfodbold og seriefodbold.ØB-historien giver også indblik i, hvordan dansk klubfodbold udviklede sig i det 20. århundrede - og ikke kun kampene mellem kridtstregerne, men i de københavnske fodboldkulisser.ØB følte sig flere gange forbigået i nogle magtspil, som giver associationer til noget af det, vi ser på internationalt niveau i dag mellem de små og de store – og dem, der føler sig hævet over de små og de store og helst kun vil spille mod hinanden.Men ØB-historien er også historien om en klub, der kun har klaret sig takket være hundredvis af frivillige ildsjæle, der har lagt et enormt stykke arbejde for at skabe rammerne – både når klubben kæmpede for livet nede i glemslens rækker, og når klubben strålede i rampelyset på det allerhøjeste niveau i dansk fodbold med store profiler som Carl Aage Præst og Helge Bronée.ØB slog sig sammen med Ryvang FC i 1998, og de spiller i dag under navnet Østerbro IF.

OL er verdens største sportsbegivenhed og det bliver kun større og større. Idrætshistoriker Jørn Hansen for tæller os lidt om historien bag, mens koordinerende fysisk træner for Team Danmark, Thue Kvorning, fortæller os om atleternes forberedelse og om livet i OL-byen, som vi ikke får lov at kigge ind i.NB: Programmet er et genudgivet program fra da Fitness M/K blev produceret hos Radio24syv. Programmet blev sendt første gang 2016-08-13. "Hejsa, det er din vært, Anders her.Hvis du gerne vil følge bedre med i hvad der sker i Fitness M/K universet, så kan du nu blive skrevet op til vores nyhedsbrev. Der vil du på månedsbasis modtage nyheder om podcasten, som nye afsnit, kommende events, tilbud fra og samarbejder med podcast gæster.Du kan blive skrevet op til nyhedsbrevet her , læse nyt fra redaktionen her, se og søge afsnit her.Jeg håber at se dig i Fitness M/K universet på www."

What do the Browns do in the draft now that Joe Flacco joins the QB room? I Dr. Tom House advises that Shohei Ohtani gives up pitching I Nikola Jokic says he was not consulted on the firing of Michael Malone.

The Trump administration recently pushed out income-driven repayment (IDR) recertification dates — some all the way to 2027. (I'm not even kidding.) But can you actually count on these extensions? We're breaking down who should trust these announcements and who might want to proceed with caution. We'll also talk about the bizarre game of musical chairs happening between government departments. One minute it's the Department of Education handling things, then suddenly it's the Small Business Administration, and now the Treasury Department's involved? It's like watching a bureaucratic shell game in real time. Listen in as we try to make sense of what's going on, what you can trust, and what steps you should take to protect yourself. Key moments: (00:51) President plans to move student loans to Small Business Administration despite questionable legality and no operational details (04:05) Trump White House surprisingly ordered an extension of borrower recertification dates to no sooner than February 2026 (07:14) Court decisions that finally put an end to the SAVE plan could force millions of borrowers into disruptive repayment plan changes (15:05) Maintain your peace of mind by focusing on what you can control in your financial life   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

(01:00): Christiania gør klar til 1-årsdag for rydning af Pusher Street - Skal fortsat være opmærksomme. Medvirkende: Hulda Mader, talsperson for Christiania. (13:00): I dag bliver det afgjort om den sydkoreanske præsident skal afsættes. Medvirkende: Morten Søndergaard, journalist tidligere bosat i Sydkorea. (37:00): Idrætsorganisationer kan drage fordel af stort 'medlemstal'. Medvirkende: Henrik Brandt, der er idrætskonsulent og fhv. direktør for Idrættens Analyseinstitut. (47:00): Økonom om Trumps toldsatser: Ingen vinder på det her. Medvirkende: Lars Christensen, økonom, CEO og medstifter af data- og analysevirksomheden Paice. Værter: Anne Phillipsen og Nicolai Dandanell See omnystudio.com/listener for privacy information.

This week on "Off the Cuff," Beth is joined by Jill and Hugh to discuss some of the latest headlines impacting student financial aid. Kicking things off on an exciting note, Beth provides some background on NASFAA's new President & CEO, Melanie Storey, who will be joining the team on May 1. Jill then shares some breaking news concerning ED's planned negotiated rulemaking session focusing on regulations that would streamline current federal student financial assistance programs with a focus on Public Service Loan Forgiveness (PSLF), Pay As You Earn (PAYE), and Income Contingent Repayment (ICR). Hugh then debriefs listeners on President Trump's executive order seeking to dismantle ED. Jill wraps things up with more updates on the application status of IDR plans that ongoing legal challenges have impacted.

In this episode of Genetics in Your World, GSA Early Career Scientist Multimedia Subcommittee member Allie Hutchings interviews Dr. Evan Dewey of Winthrop University about the functions of Blm helicase N-terminal IDR. Read Dr. Dewey's paper titled, “Functions of the Bloom syndrome helicase N-terminal intrinsically disordered region,” published in the March 2025 issue of GENETICS: https://doi.org/10.1093/genetics/iyaf005. Music: Loopster Kevin MacLeod (incompetech.com). Licensed under Creative Commons: By Attribution 3.0 License, http://creativecommons.org/licenses/by/3.0/ Podcast Notes:Bloom syndrome helicase (Blm) has important roles in maintaining genome stability. About half the protein is predicted to be intrinsically disordered (IDR), and its functions are poorly understood. The authors of this study identified regions that are locally conserved in closely related Drosophila species, then deleted these and assayed various functions. They find that each region is required for a subset of Blm functions. The authors' modeling suggests these regions adopt structure in complex with Top2alpha and the results provide novel insights into Blm IDR functions. Dr. Evan Dewey would like to acknowledge the following colleagues: Colleen C. Bereda, Dr. Jeff Sekelsky, Dr. Christopher A Johnston, Denise Soroka, Dr. Mitch McVey, Carolyn Turcotte, Dr. Nila Pazhayam, Mohamed A. Nasr, Priscila Santa Rosa, Susan McMahan, Dr. Robert J. Duronio, Dr. Gregory Matera, Dr. Dan McKay, and Dr. Richard Cripps.Thank you to the GSA Early Career Scientist Multimedia Subcommittee, in particular the production team who worked on this episode: Allie Hutchings, Interviewer; Sarah Shahba and Laetitia Chauve, Researchers. Hosted on Acast. See acast.com/privacy for more information.

Student loans are a mess. They've been a mess for as long as we've been doing this, but right now? It's like someone took that mess, threw it in a blender, and hit "puree." We're answering a whole heap of listener questions. This episode is dropping on April Fool's Day, but no jokes or pranks here — just straight-up answers. Let's face it: the real joke is how convoluted this whole system has become. But we're tackling the questions head-on. And if you're one of the folks who sent in questions, thanks for trusting us with your financial headaches. We've got your back. Key moments: (04:34) The trap that will mean big trouble for borrowers if ICR gets repealed (12:06) No “processing shortcuts” exist — everyone's in the same slow-moving line (21:20) Inexperienced customer service representatives giving you the wrong answers (34:06) Why you might want to file a tax extension to see how student loan policies might shift (45:24) Financial windfall? Where to direct your cash for maximum impact Links mentioned: StudentAid.gov IDR plan request Certify employment for Public Service Loan Forgiveness (PSLF) Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

Student loans — especially under income-driven repayment (IDR) plans — continue to be one of the most asked-about topics among ER docs. With all the recent changes, pauses, and legal uncertainty, figuring out what to do next has become increasingly difficult. We're recording this episode to help break down the latest updates, including the major change as of February 21st that halted all IDR applications, and to answer some of the most common questions we've been hearing. If you're pursuing PSLF, on SAVE, PAYE, or just trying to make sense of it all — this episode's for you.

Questions? Thoughts? Send a Text to The Optometry Money Podcast!In this episode, Evon Mendrin, CFP® dives into the latest twists in the federal student loan landscape—and what they mean for optometrists using income-driven repayment (IDR) plans. There's big news on SAVE plan court rulings, loan consolidations, and IDR recertifications. But more than that, Evon explores the deeper question: What are the tradeoffs you accept when choosing an IDR path toward forgiveness?Whether you're a recent graduate figuring out your repayment plan or a practice owner managing loans alongside business goals, this episode breaks down the current student loan climate and the ongoing volatility—and why you should base your decision on math and personal tolerance for policy uncertainty.

The IDR recertification deadline has been pushed back again — this time, to no sooner than February 2026. And while that might sound like good news on the surface, we know it brings up a ton of questions. That's exactly what we're unpacking in this episode.   If you're on an income-driven repayment (IDR) plan or even thinking about it, tune in as we answer listener questions about what the new extension actually means for your monthly payments, whether it makes sense to start paying again now or keep riding the pause, and how this might (or might not) affect forgiveness programs down the road. Get insights and practical strategies to stay on top of your plan without going into a tailspin.   Key moments:   (00:31) Why it's important to be extra careful filing taxes this year (02:57) Paper vs. online IDR applications and why some are mailing backups (11:24) If you're in the Sweet v. Cardona group, is IBR worth it? (13:15) PSLF questions around buyback, forbearance, and filing a tax extension (19:35) What we know about the ongoing IDR application processing delays   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

Intervention du dimanche 23 mars 2025 de Idrîs De Vos dans le cadre du cycle Ramadan "Le Coran, parole de vie" À l'occasion du mois de Ramadan 1446/2025, Conscience Soufie invite quelques femmes et hommes inspirés à témoigner de la façon dont ils furent saisis par le verbe coranique. Ils choisiront une thématique qui leur est chère et qu'ils ont envie de partager. Une parole lourde (thaqîl) capable de pulvériser les montagnes, voici comment le Coran se présente. Mais il est aussi descendu sur terre telle une pluie d'étoiles (tanjîman) par effet de la Miséricorde, et ne cesse de s'offrir aux cœurs sincères. Au fil de ces diverses rencontres, il ne s'agira pas d'exposer une exégèse savante, mais de faire état d'expériences transformatrices dans le face à face avec le sacré. « CONSCIENCE ET MÉDITATION DANS LE CORAN » La science des « objectifs coraniques » (ghayât ou maqâṣîd) intéresse les savants musulmans depuis des siècles, car son objet n'est rien de moins que de sonder l'essentiel du message coranique. Or, au cœur de cet essentiel, se situe la conscience. Comment ce mystère est-il abordé dans le Coran ? Et comment la méditation œuvre-t-elle à vivifier et à fertiliser cette conscience ? Idrîs de Vos est auteur, traducteur et enseignant d'arabe et de tafsir. Il est également le créateur de la méthode « L'arabe Coranique » en 3 tomes et le fondateur de l'Institut Imtiyaz. Né dans l'univers de la mystique musulmane et Diplômé de la Sorbonne en langue et civilisation arabes, il a beaucoup traduit les auteurs soufis, notamment Ghazali, et a écrit sur des thèmes importants comme celui de l'amour. C'est dans ce cadre qu'il a publié son livre « L'amour universel un cheminement soufi ». Pour plus informations: https://consciencesoufie.com/

Om at løbe rigtigt, rigtigt langt - Ekstrem- og ultraløb. Idrætskulturen polariseres på mange måder og folk dyrker vildere og vildere ting. I dag har Fitness M/K besøg af Moses Løvstad og Claus Rasmussen aka Posemanden. De tegner en del af de danske langtløbermiljø og de er i studiet til en snak om selve det at løbe langt. Hvordan føles det under og efter, hvordan træner de og hvem er det, der løber de her sindssygt lange løb? Hvad er det, der får dem til at gøre noget så smertefuldt ved sig selv og så alligevel beslutte at gentage det et halvt år senere? Anders Fabricius NedergaardNB: Programmet er et genudgivet program fra da Fitness M/K blev produceret hos Radio24syv. Programmet blev sendt første gang 2016-06-18.. Programmet blev sendt første gang 2016-06-18. "Hejsa, det er din vært, Anders her.Hvis du gerne vil følge bedre med i hvad der sker i Fitness M/K universet, så kan du nu blive skrevet op til vores nyhedsbrev. Der vil du på månedsbasis modtage nyheder om podcasten, som nye afsnit, kommende events, tilbud fra og samarbejder med podcast gæster.Du kan blive skrevet op til nyhedsbrevet her , læse nyt fra redaktionen her, se og søge afsnit her.Jeg håber at se dig i Fitness M/K universet på www."

Listen in with VIN Foundation board member and Student Debt Education lead Dr. Tony Bartels in this next installment of our Student Debt Series. In this episode we're covering the latest news on income-driven repayment application changes    Topics covered included: What happened to the Income-Driven Repayment application? If borrowers are using an income-driven payment plan right now, what should they do? How do these changes impact monthly payments for borrowers? How about borrowers who are hoping for PSLF? How do the recent changes impact them? What's the best approach for borrowers when dealing with loan servicers?   As always, we want to hear from YOU. Please share your thoughts by sending an email or joining the conversation.     NOTE: This is an ongoing situation, for continued updates visit the VIN Foundation Blog and student debt message board areas.   GUEST BIO: Dr. Tony Bartels Tony Bartels, DVM, MBA graduated in 2012 from the Colorado State University combined MBA/DVM program and is a VIN Foundation Board Member and Student Debt Expert, and an employee of the Veterinary Information Network (VIN). He and his wife, a small-animal internal medicine specialist practicing in Denver, have more than $400,000 in veterinary-school debt that they manage using federal income-driven repayment plans. By necessity (and now obsession), his professional activities include researching and speaking on veterinary-student debt, providing guidance to colleagues on loan-repayment strategies and contributing to VIN Foundation resources. Beyond debt, his professional interests include small- and exotic-animal practice. When he's not staring holes into his colleagues' student-loan data, Tony enjoys fly fishing, ice hockey, camping and exploring Colorado with his wife, Audra, daughter, Lucy, and their two rescued canines, Addi and Maggie.   LINKS AND INFORMATION: VIN Foundation Student Debt Center: https://vinfoundation.org/studentdebtcenter Time for your student loan physical exam? VIN Foundation My Student Loans tool http://www.vinfoundation.org/mystudentloans VIN Foundation Download My IDR Progress Google Chrome extension to help you grab a copy of your IDR forgiveness progress VIN Foundation Blog, most recent: All IDR applications for student loans are paused – Now what? February 2025 Q&A from Climbing Mt. Debt Webinar: What's Next for your Student Loans? VIN Foundation Navigating Uncertainty Checklist, what you can do now: https://vinfoundation.org/wp-content/uploads/2025/03/VIN-Foundation-What-You-Can-Do-Now-Navigating-Student-Loan-Uncertainty.pdf Climbing Mt. Debt webinar: What's Next for Your Student Loans? by VIN and VIN Foundation, February 5th, 2025: https://vinfoundation.org/resources/repay-wiser-veterinary-school-debt-loan-repayment/#MostRecentWebinar  VIN Foundation Relevant WikiDebt Resources: IDR Profiles: What is your IDR profile? IDR Discretionary income calculations Personalized student loan help from VIN and VIN Foundation: https://vinfoundation.org/veterinary-student-loan-debt-help/  Department of Education Updates on Saving on a Valuable Education (SAVE Plan):  https://studentaid.gov/announcements-events/save-court-actions https://www.ed.gov/save https://studentaid.gov/  VIN Foundation get updates: https://vinfoundation.org/updates/ VIN Foundation GIVE page to support programs these programs & tools: https://vinfoundation.org/give Have a veterinary story you want to share? https://share.hsforms.com/1e6QkQvg2RI-wpDv59Byqkwcos60 Stay up to date with VIN Foundation updates: https://vinfoundation.org/updates/ Email VIN Foundation: studentdebt@vinfoundation.org If you like this podcast, we would appreciate it if you follow and share. As always, we welcome feedback. If you have an idea for a podcast episode, we'd love to hear it!

The IDR and loan consolidation applications are down, repayment plans are shifting, and court rulings are throwing everything into question. If you're feeling stuck, you're not alone. Learn why the Department of Education is reworking the IDR and PSLF applications, what this means for your loan strategy, and how to make smart decisions despite the chaos. We'll also tackle listener questions about PSLF timing, repayment plan changes, and what potential policy shifts could mean for your forgiveness path. Key moments: (04:38) What the court ruling means for PSLF and ICR borrowers (07:16) Will my loans be forgiven? I'm two payments away from forgiveness and not IBR eligible (14:51) Is my income too high to qualify for financial hardship? (19:24) Do my Parent PLUS loans qualify for PSLF forgiveness? (23:06) What is the student loan “tax bomb” and will I have to pay it? Link mentioned:   Request an income-driven repayment plan   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

Subscribe to our channel: https://www.youtube.com/@optispanThomas DeLauer & I (Dr. Matt Kaeberlein) discusses his evolving perspectives on nutrition, exercise, and health optimization. Thomas shares how his views on insulin, low-carb diets, and fructose have shifted, his approach to training for strength and longevity, and the importance of sleep, emotional well-being, and recovery. Delauer also touches on peptides, supplements, and wearable tech, providing valuable takeaways for those looking to improve their performance, body composition, and overall health.0:00 - Introduction & Thomas DeLauer's evolving views2:10 - The challenge of simplifying health content4:57 - Shifting perspectives on nutrition & health goals7:55 - Low-carb lifestyle & insulin reconsidered12:49 - A day in the life: Diet, fasting & protein intake19:04 - Strength training, cardio & hybrid workouts25:45 - Sleep optimization & recovery strategies30:11 - Emotional health, connection & mindfulness36:02 - Peptides, supplements & risk vs. rewardProducers: Tara Mei, Nicholas ArapisVideo Editor: Jacob KeliikoaDISCLAIMER: The information provided on the Optispan podcast is intended solely for general educational purposes and is not meant to be, nor should it be construed as, personalized medical advice. No doctor-patient relationship is established by your use of this channel. The information and materials presented are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. We strongly advise that you consult with a licensed healthcare professional for all matters concerning your health, especially before undertaking any changes based on content provided by this channel. The hosts and guests on this channel are not liable for any direct, indirect, or other damages or adverse effects that may arise from the application of the information discussed. Medical knowledge is constantly evolving; therefore, the information provided should be verified against current medical standards and practices.More places to find us:Twitter: https://twitter.com/optispanpodcastTwitter: https://twitter.com/optispanTwitter: https://twitter.com/mkaeberleinLinkedin: https://www.linkedin.com/company/optispanInstagram: https://www.instagram.com/optispanpodcast/TikTok: https://www.tiktok.com/@optispanhttps://www.optispan.life/Hi, I'm Matt Kaeberlein. I spent the first few decades of my career doing scientific research into the biology of aging, trying to understand the finer details of how humans age in order to facilitate translational interventions that promote healthspan and improve quality of life. Now I want to take some of that knowledge out of the lab and into the hands of people who can really use it.On this podcast I talk about all things aging and healthspan, from supplements and nutrition to the latest discoveries in longevity research. My goal is to lift the veil on the geroscience and longevity world and help you apply what we know to your own personal health trajectory. I care about quality science and will always be honest about what I don't know. I hope you'll find these episodes helpful!

Last night, I went live to break down the latest developments in student loans, and trust me, there's a lot happening. First, we discussed the IDR injunction—why it's blocking all applications, what it means for borrowers, and what to expect next. Then, we dove into the budget reconciliation bill, which includes some major student loan changes that could impact repayment plans, forgiveness programs, and more. But here's the real question: What are the chances these changes actually pass? If you have student loans, you don't want to miss this episode. Tune in now to stay ahead of the game and make informed decisions about your financial future! If you need help with your finances, we'd love to help you find financial peace of mind. Be sure to become a Member of FitBUX today.  

Man kan man føle sig både utryg og uøvet, når man begiver sig ind i et træningscenter.'Måske føler du dig ikke selvsikker omkring den træning du skal lave, eller også føler du, at du mangler erfaring.Så kan du faktisk give dig selv følelsen af erfaring, ved at visualisere træningssituationen, og mentalt øve dig på, hvordan du ønsker at udføre den.Men visualisering er ikke kun et redskab for nybegyndere i træningscenteret - det er også for dig, der virkelig vil optimere din træning og styrke.Det tager Nikolaj en snak om med Michael, der er træner i Styrk Aalborg, Bsc. i Idræt og ægte visualiserings-nørd.---Vores nye Facebook-side:⁠⁠https://www.facebook.com/share/164cMDXwuS/⁠⁠Få en gratis træning på Træningsklubben i Aalborg eller Aarhus:https://go.styrkmig.dk/lokationBliv medlem af Træningstimens gruppe på FB, og få svar på dine spørgsmål om træning og kost:https://www.facebook.com/groups/traeningstimenFå en uforpligtende samtale om din målsætning:https://styrkmig.dk/booking/Tjek vores "Stærk hver dag" t-shirt:https://styrkmig.dk/vare/styrk-t-shirt/

Does Las Vegas make sense for Matthew Stafford? I Dr. Rock Positano, Podiatrist at HHS I Did Pat Riley ruin the Heatles?

This week on "Off The Cuff," Beth and Karen are joined by Megan and Jill to discuss multiple updates from the Department of Education (ED). Karen kicks off the episode by debriefing listeners on ED's Dear Colleague Letter (DCL) that directed institutions to cease using race preferences as a factor in admissions, financial aid, hiring, training, and other institutional programming, or be at risk of losing federal funding. Megan then discusses the latest updates with income-driven repayment (IDR) plans, including ED taking down the online application for the Saving on a Valuable Education (SAVE) program and other income-based plans. From there, Jill unpacks the availability of batch correction functionality for the 2024-25 and 2025-26 FAFSA, and what financial aid professionals can expect. Lastly, the team discusses Linda McMahon's pending confirmation as ED secretary, and the pending executive order from President Donald Trump that could seek to dismantle ED. 

The student loan landscape is a mess — uncertainty, delays, conflicting headlines, and a whole lot of anxiety. Should you switch repayment plans? Are you eligible for PAYE? And how could political changes impact Grad PLUS loans and Public Service Loan Forgiveness (PSLF)? We're answering real borrower questions and sharing practical steps you can take right now so you don't get caught off guard by sudden changes. If you're feeling stuck, overwhelmed, or just unsure of your next step, this episode is for you.   Key moments:   (06:08) Should you switch to a new IDR plan or stick with SAVE? (13:19) Could an executive order eliminate Grad PLUS loans? (19:32) Can DOGE change access to PSLF or IDR forgiveness? (25:23) Taking time off for kids? Here's how to manage student loan repayment during career breaks (32:43) What to expect with student loans and income recertification Link mentioned:   Income-Driven Repayment (IDR) plan request   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

A lot of borrowers are concerned about what would happen if the Department of Education gets eliminated. We'll walk through exactly what can and can't change based on the law, from Public Service Loan Forgiveness (PSLF) and Income-Driven Repayment (IDR) plans to the impact on your student loans. Plus, I'll give you clear guidance and action steps to prepare your finances. If you're worried about recertifying your income or wondering if you should refinance, this episode will help calm your nerves and give you practical steps to protect yourself.   Key moments:   (03:20) Your IDR payments could spike if you don't plan for how you'll file your tax return (04:54) Potential PSLF and IDR program changes that could affect your forgiveness (10:24) What a Department of Ed shakeup could mean for your student loans (14:33) The debt-to-income formula that determines your best loan strategy (19:41) The reconciliation bill could reshape IDR programs   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!

Confirmation battles are heating up, and student loan policy hangs in the balance. Linda McMahon is set to take over the Department of Education, but will her past come back to haunt her? More importantly, who will actually be in charge of student loan decisions? We address why student loans have been on the back burner, what could change, and how much power the Trump administration really has over repayment plans, IDR adjustments, and recertifications. Plus, we tackle must-hear listener questions to help you navigate shifting student loan policies, avoid costly missteps, and make the best decisions for your repayment strategy. Key moments: (00:43) Linda McMahon's confirmation is all but certain, despite past allegations (05:56) Who will shape Trump's student loan policy? With confirmation battles ahead, there's no clear leader yet(06:46) Student loans aren't a priority for Trump's education team — where does that leave borrowers? (15:00) Over 300 qualifying payments and still waiting… should you switch repayment plans, or does it even matter? (20:46) Could Trump erase the IDR account adjustment? Yes, but it isn't likely (32:14) IDR recertification is in Trump's hands, and borrowers need to be ready with the right tax returns Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!

Skal hele Danmark takke de jyske håndboldhaller for guldet? Var det provinsen der sejrede i VM i herrehåndbold i Oslo? Er håndbold klappepølser og lavkultur? Er fodbold kunst og højkultur? Eller er håndbold begavet og stærkt undervurderet? Du kan blande dig i debatten ved at ringe ind fra 12:15-13:30 på 7021 1919 eller send en sms til 1212. Medvirkende: Jakob Engel-Schmidt (M), Kulturminister, Louise Elly Meyer, håndboldspiller/journalist Heartbeats, Malte Tellerup, forfatter, selverklæret håndbolddreng, Mikkel Tofte Langerhuus, journalist/ tidligere elitehåndboldspiller, Rasmus K. Storm, analyse- og forskningschef, Idrættens Analyseinstitut, Dorte West, (V) borgmester Herning og Kurt Lassen, sportsredaktør POV, skrevet biografi om bl.a Nikolaj Jacobsen. Tilrettelægger: Nina Lorenz Grimstrup. Vært: Gitte Hansen.

In this episode I'm really excited to introduce you to Dr. Aimie Apigian. She is the author of the book "The Biology of Trauma" and specializes in helping people recover from trauma using somatic therapy and “parts work,” which is a form of psychotherapy developed by Dr. Richard Schwartz. As listeners know, I (Dr. Doni) have been researching and writing about stress and trauma for over 30 years. I feel it is imperative that we support patients to recover from stress and trauma, which is how I developed my Stress Recovery Protocol, and why I continue learning modalities, and teaching courses, on how to help humans heal. This is why I'm so glad to share Dr. Aimie's expertise with you in this episode. Most of us are exposed to some form of stress or trauma, whether we realize it or not. The body holds memories from the past that we don't even remember logically - it's not even in our conscious mind, and yet our body holds the memories of all of that. This makes it such an important topic to discuss. We're here to help you! LINKS FROM THE EPISODE:   Join Dr. Aimie's 21 Day Journey to Calm Aliveness: https://traumahealingaccelerated.mykajabi.com/a/2147704575/LPnkwbhr    Take Dr. Doni's Stress Type Quiz: https://doctordoni.com/quiz/stress-quiz/    Sign up For Dr. Doni's Free Masterclass: https://drdoni.lpages.co/menopause-masterclass/     Schedule A Chat With Dr. Doni: https://intakeq.com/new/hhsnib/vuaovx    Read the full episode notes and find more information: https://doctordoni.com/blog/podcasts/ MORE RESOURCES FROM DR. DONI:   Quick links to social media, free guides and programs, and more: https://doctordoni.com/links     Disclosure: Some of the links in this post are product links and affiliate links and if you go through them to make a purchase I will earn a commission at no cost to you. Keep in mind that I link these companies and their products because of their quality and not because of the commission I receive from your purchases. The decision is yours, and whether or not you decide to buy something is completely up to you.

I'm thrilled to have John Swallow, CEO of Idaho Strategic, back on the podcast. John has been one of my favorite guests over the years. He's built Idaho Strategic $IDR from a near-bankrupt entity to a $160M+ company today (as of this podcast). I first had John on the podcast last February. Things were a lot different then. Gold is much higher now. IDR is profitable. They have no net debt. But John isn't satisfied. He's building a real company. One that will last for decades after he's gone. This is the story on how he plans to do that, what makes IDR unique, and why building a business by starting small still makes sense. Finally, a big thanks to our sponsors for making this episode happen. Mitimco This episode is brought to you by MIT Investment Management Company, also known as MITIMCo, the investment office of MIT. Each year, MITIMCo invests in a handful of new emerging managers who it believes can earn exceptional long-term returns in support of MIT's mission. To help the emerging manager community more broadly, they created ⁠⁠⁠⁠emergingmanagers.org⁠⁠⁠⁠, a website for emerging manager stockpickers. I highly recommend the site for those looking to start a stock-picking fund or just learning about how others have done it. You'll find essays and interviews by successful emerging managers, service providers used by MIT's own managers, essays MITIMCo has written for emerging managers, and more! TIKR TIKR is THE BEST resource for all stock market data, I use TIKR every day in my process, and I know you will too. Make sure to check them out at ⁠⁠⁠⁠TIKR.com/hive⁠⁠⁠⁠.

With a new Trump administration taking office, the next 100 days could shape the future of student loans in America. We're breaking down what we're watching and what these potential changes could mean for borrowers.   Key moments:   (01:06)  The GOP's budget reconciliation bill and how it could impact borrowers nationwide (03:46) A closer look at the proposal to end time-based forgiveness and require full repayment of principal plus interest (05:03) How student loans factor into the GOP's proposed spending cuts and what might happen next (10:16) Will the Biden administration's IDR account adjustments survive under GOP leadership?   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

We'll look ahead at major changes in student loan repayments under the new Trump administration, with potential IDR recertification deadlines and implications of the 8th Circuit's decisions. Plus, I'll share a personal story about an investment mistake that cost me thousands and tips so that it doesn't happen to you.   Key moments:   (01:28) Student loan collections are restarting: what it means for your credit and forbearance (03:49) What cost basis is (and a personal story about how ignoring it cost me thousands) (09:49) Are AUM fees worth it? Breaking down the math (15:06) Understanding technical investing strategies can give you an edge in wealth-building Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

Are deepfakes a threat to modern security, or can AI turn the tide in fraud prevention? In this episode of A Journey Into Fraud Prevention, we delve into the fascinating intersection of AI, deepfakes, and security with Konstantin Simonchik, Chief Scientific Officer and co-founder of IDR&D. Join us as Konstantin shares his expert knowledge in biometrics and AI-driven security solutions, exploring how fraudsters use AI tools like deepfakes—and how cutting-edge technology is combating these threats. Through real-time demonstrations, insights into AI-enhanced fraud trends, and career advice for fraud prevention enthusiasts, this episode offers invaluable takeaways for anyone interested in AI, cybersecurity, and fraud detection.

The clock is ticking on the double consolidation loophole for Parent PLUS Loans, which closes in July 2025. Learn what this change means, why borrowers must act quickly, and how to make the most of the remaining time. We'll tackle the big questions: Should you file taxes jointly or separately? How do Medicare penalties and student loan repayments overlap? And what strategies can help you maximize income-driven repayment (IDR) plans before the loophole disappears? Jared Costigan, CFP®, CSLP®, a financial planner with the SLP Wealth team, shares expert advice on preserving retirement savings, aligning Social Security with loan repayment, and leveraging Public Service Loan Forgiveness (PSLF). Key moments: (05:16) Parent PLUS debt surged 63% from 2015 to 2022 as the cost of college climbs (9:19)  The double consolidation loophole could save you from paying 20% of your retirement income (19:38) Who benefits most from a double consolidation? Borrowers with balances nearing or exceeding their income (27:56) Income planning ties Social Security and loans to retirement timing — don't overlook it (37:32) Filing taxes separately can lower loan payments but may raise Medicare costs Links mentioned:    Financially Free Physicians podcast Department of Education Parent PLUS Loans Parent PLUS Double Consolidation Loophole Guide for 2025   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

Meet again Joe Sherman. Joe grew up in a family being the youngest of seven siblings. His parents who had not gone to college wanted their children to do better than they in part by getting a college education. Joe pretty much always wanted to go into medicine, but first obtained a bachelor's degree in engineering. As he said, in case what he really wanted to do didn't pan out he had something to fall back on.   Joe, however, did go on and obtain his MD and chose Pediatrics. He has been in the field for 35 years.   This time with Joe we talk a lot about the state of the medical industry. One of Joe's main efforts is to educate the medical profession and, in fact the rest of us, about burnout among medical personnel. Joe tells us why burnout is so high and we discuss what to do about it. Joe talks about how the medical profession needs to change to keep up with the many challenges faced by doctors and staff and he offers interesting and thought-provoking ideas. Again, I hope you will find my discussion with Joe Sherman beneficial, productive and helpful to you, especially if you are a doctor.       About the Guest:   Dr. Joe Sherman helps health professionals transform their relationship with the unrelenting demands of their jobs and discover a path toward meaning, professional fulfillment, and career longevity. He believes the key to personal and professional success lies in bringing “soul to role” in your medical practice.   Dr. Sherman is a pediatrician, coach and consultant to physicians and healthcare organizations in the areas of cross-cultural medicine, leadership, and provider well-being.  He is a facilitator with the Center for Courage & Renewal and a Master Certified Physician Development Coach with the Physician Coaching Institute.   Dr. Sherman has been in pediatric practice for over 35 years concentrating on healthcare delivery to underserved and medically complex children in the District of Columbia, Tacoma, Seattle, Uganda, and Bolivia.  He has held numerous faculty positions and is currently Clinical Associate Professor of Pediatrics at the University of Washington.   Ways to connect with Dr.Joe:   My website is: https://joeshermanmd.com/   LinkedIn: www.linkedin.com/in/joeshermanmd   Direct email connection: joe@joeshermanmd.com       About the Host:   Michael Hingson is a New York Times best-selling author, international lecturer, and Chief Vision Officer for accessiBe. Michael, blind since birth, survived the 9/11 attacks with the help of his guide dog Roselle. This story is the subject of his best-selling book, Thunder Dog.   Michael gives over 100 presentations around the world each year speaking to influential groups such as Exxon Mobile, AT&T, Federal Express, Scripps College, Rutgers University, Children's Hospital, and the American Red Cross just to name a few. He is Ambassador for the National Braille Literacy Campaign for the National Federation of the Blind and also serves as Ambassador for the American Humane Association's 2012 Hero Dog Awards.   https://michaelhingson.com https://www.facebook.com/michael.hingson.author.speaker/ https://twitter.com/mhingson https://www.youtube.com/user/mhingson https://www.linkedin.com/in/michaelhingson/   accessiBe Links https://accessibe.com/ https://www.youtube.com/c/accessiBe https://www.linkedin.com/company/accessibe/mycompany/   https://www.facebook.com/accessibe/       Thanks for listening!   Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below!   Subscribe to the podcast   If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can subscribe in your favorite podcast app. You can also support our podcast through our tip jar https://tips.pinecast.com/jar/unstoppable-mindset .   Leave us an Apple Podcasts review   Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts.       Transcription Notes:   Michael Hingson ** 00:00 Access Cast and accessiBe Initiative presents Unstoppable Mindset. The podcast where inclusion, diversity and the unexpected meet. Hi, I'm Michael Hingson, Chief Vision Officer for accessiBe and the author of the number one New York Times bestselling book, Thunder dog, the story of a blind man, his guide dog and the triumph of trust. Thanks for joining me on my podcast as we explore our own blinding fears of inclusion unacceptance and our resistance to change. We will discover the idea that no matter the situation, or the people we encounter, our own fears, and prejudices often are our strongest barriers to moving forward. The unstoppable mindset podcast is sponsored by accessiBe, that's a c c e s s i capital B e. Visit www.accessibe.com to learn how you can make your website accessible for persons with disabilities. And to help make the internet fully inclusive by the year 2025. Glad you dropped by we're happy to meet you and to have you here with us.   Michael Hingson ** 01:21 Well, hi all. This is your host, Mike hingson, and welcome to another episode of unstoppable mindset. And today we are meeting once again with Dr Joe Sherman. And if you remember our last show, Dr Sherman is a board certified pediatrician and master certified physician development coach, and I won't give any more away, because it's more fun to talk to him about all of that. But we had such an interesting discussion, it just seemed like what we ought to do is to have a continued discussion, because we didn't get to cover everything that he provided to us last time, and and I know we've probably got lots more that we can add to the discussion. So, Joe, welcome to unstoppable mindset. We're glad you're here   Dr. Joe Sherman ** 02:10 again. Thanks so much for having me. Michael, it's good to be back.   Michael Hingson ** 02:13 Well, glad you're here and all that. Do you want to start by kind of, maybe refreshing people about you a little bit life and all that, any anything that you want to give us just to start the process? Sure,   Dr. Joe Sherman ** 02:25 I currently live in Seattle, Washington with my wife. We have a few grown children that are in their early 20s, and I am a pediatrician, and now am a physician professional development coach, and I facilitate retreats for health professionals, medical teams, and most of my focus is on trying to bring who we are to what we do kind of being more authentically who we are in our workplace, trying to come to our work with a more balanced mindset, and trying to work A little bit more collegially as medical teams in today's ever changing health care environment. So now, I have practiced for about 35 years in pediatrics, and am now devoting all of my time to coaching and facilitation. You   Michael Hingson ** 03:37 know, gosh, there's so many, so many things that would be interesting to discuss, and I do want to stay away from the whole idea of politics, but at the same time, what do you think about the whole way the medical profession, you know, of course, one of the things that comes to mind is just everything that happened during COVID. But what do you think about the way the medical profession and some of the things that the profession is trying to do is being treated by politicians, and a lot of times it seems like people don't take it seriously, or it just doesn't fit into their agenda. Does that make sense?   Dr. Joe Sherman ** 04:15 You mean, as far as so as a pandemic was concerned? Well, the   Michael Hingson ** 04:20 pandemic, or, you know, there were some discussions about end of life or life discussions, and some people poo pooed, having that kind of thing and saying that isn't something that doctors should be doing. Oh,   Dr. Joe Sherman ** 04:33 I think, right now, I think that politics and healthcare are intricately entwined. Especially after the pandemic, and I think right now, the idea of the politics getting in the way of a kind of. The doctor patient relationship is, is challenging. It's challenging for healthcare workers. I think where we desperately need political courage is in trying to develop a healthcare system that works for everybody in the country. So I think that that's where the focus should be.   Michael Hingson ** 05:21 What do you think about? And I've had a number of people tell me, single pay healthcare system wouldn't be a good thing. It's too socialistic, and we'll leave that out of it just wouldn't be a good thing. It seems to me that it has been very successful in a number of places, but the kinds of arguments that people give are well, but by having competition, we have been a lot better at producing new and innovative technologies that wouldn't be produced or wouldn't be provided if we had just a single pay kind of system. I don't know whether that makes sense or I'm expressing it the best way, but it just seems like there's an interesting debate there. I   Dr. Joe Sherman ** 06:03 think there is debate because I do think there is some truth in the statement that our health care system has enabled development of technology and research in ways, perhaps that other countries have not. On the other hand, our health outcomes and our health access for people who live in this country is not very good, especially given the degree of wealth that our country has. So I used to joke, although it's not that funny, but one clinic where I worked that was a low income clinic, I used to joke that if one of our patients were to come out of their apartment To cross the street to come to the clinic. They may be turned away at the door because they don't have any insurance, or they don't have the proper insurance, or they can't pay but if they happen to be get run over by a car in the street on their way across the street, there would be no questions asked. The ambulance come pick them up. They'd be taken to the emergency room, given the best treatment to try to save their lives, admitted to the ICU and incur a huge medical bill with the greatest of technology, but they would not have been able to have gotten that primary care appointment to be in with. Yeah. So we are very kind of high tech, high intensity, high specialized in our approach to health care, whereas other countries focus much more on primary care.   Michael Hingson ** 07:54 I know in 2014 in January, my wife became ill. Started out as bronchitis, and it kept getting worse, and she didn't want to go to the hospital, but, and she was always in a wheelchair, so she she found that they didn't really know how to deal with can Well, she was congenital or always paralyzed from basically t3 from the breast down, and she so she didn't like to go, but finally, we compelled her to go to the hospital. And was on a Saturday, and the next day, the bronchitis morphed into double pneumonia and ARDS, and her lungs ended up being 90% occluded, so she had to even to get air into her lungs, they had to use a ventilator, and she had a peeps level of 39 just to get air into her lungs. Yeah, you know what that that means. And it was, it was pretty amazing. People came from all over the hospital just to watch the gages, but she had literally, just about turned 65 and we were very blessed that we didn't get any bill because Medicare, I Guess, absorbed the entire thing, and we we, we didn't know whether, whether we would get anything or not, and we didn't. And she did recover from that, although she felt that she had coded a couple times, and then her brain wasn't quite as good as it had been, but, but she did well, and so we got incredible care from Kaiser Terra Linda up in the San Rafael area, and it all went well. Of course, I we had gotten the pneumonia shots, and I complained to our physician to talk about joking. I complained to our primary care physician. I. Well, you say that these shots are supposed to keep it from happening, but we both had the shots and and, and she got double pneumonia anyway. Of course, the unfortunate thing was that that the doctor had an answer. She said, Yeah, but it would have been worse if he hadn't gotten the shot. Darn. She shot me down, but it was fun to joke.   Dr. Joe Sherman ** 10:18 Well, I'm sorry that that happened to you that that's, that's a unfortunate situation, it   Michael Hingson ** 10:26 was, but you know, things, things do happen and and we did get over it. And out of that, we ended up moving down to Southern California to be closer to to family. So it worked out okay. But we we love the and really support the medical system in any way that we can. We see both of us did, and I still, you know, and wherever she is, she must see the value of of what's done. And it just is so frustrating anytime people say doctors are crazy people. They don't, they don't really look out for people's interest, and just so many different things. It, it's unfortunate, because, you know, I can tell you from personal experiences. I just said what we saw,   Dr. Joe Sherman ** 11:16 yeah, I think that what is happening in our healthcare system now is this epidemic of burnout amongst professionals, especially amongst physicians and nurses, but and a lot of that has to do with the amount of administrative tasks and the amount of pressure that's put on physicians and other health care providers in trying to see as many patients as they can in the shortest amount of time as possible, and this is because of our system of fee for service reimbursement for medical care, the way that that health systems stay afloat is by trying to see as many patients as possible, and this unfortunately, combined with the amount of administrative work that needs to be done for each of those visits, plus the amount of communication that comes in from patients, as well as referral sources and requests for prescription refills, all of that comes in constantly through the computer of any physician that's trying to work as an outpatient or inpatient doctor, and it just becomes overwhelming,   Michael Hingson ** 12:43 yeah, how do we fix that? That's a good loaded, general question, isn't   Dr. Joe Sherman ** 12:50 it? It is it is a good question. And I I think it's a multi pronged approach. I do think that one thing that has happened is that the technology of healthcare and the business of healthcare has changed dramatically during the time that I've been a physician, a pediatrician, and the culture of healthcare, kind of, the way we do things, really hasn't changed. So that means that the business and the technology has placed more demands on us, and at the same time, we're kind of doing things pretty much the same way we've always done them, because of these extra demands that are placed on physicians and other health professionals, what's needed are experts that are in those areas of billing, administrative, administration, technology, it all of those things that now all feed into seeing patients in the office or in the hospital. So you need all of those professionals working together side by side along with the physician, allow the physician to do the work that she's been taught to do, which is actually deal with the patient and take care of the patient, and then let other people do the data entry, do the billing, take care of all of the messages and other things that are coming in around that that that provider. Do   Michael Hingson ** 14:23 you think that the same level of burnout exists in other countries that exists here?   Dr. Joe Sherman ** 14:29 You know it does. I do think that burnout exists everywhere in healthcare. I do think that it is less in low income countries, which seems kind of strange, but I've worked for many years in my life in low income countries in Africa as well as South America. And it's a different culture. It's a different culture. Culture of health care there is, there are different expectations of doctors, I think, in other countries, especially countries that are used to seeing a lot of disease and mortality, the pressure on saving lives and the pressure on having to be perfect and always get it right and knowing everything to do it each time that a patient comes in is not quite as intense as it is here. So I do think that it is different in other places. However, I will say that I have spoken to physicians in definitely in the more developed, higher income world, parts of the world that this epidemic of burnout is pretty universal   Michael Hingson ** 15:57 now, It seems to me that I've been seeing in recent years more what they're called physician assistants. Is that a growing population, or is it always been there, and I just haven't noticed it? And does that help?   Dr. Joe Sherman ** 16:14 I do think that in our country, here in the US, the future, will see many more physicians assistants and nurse practitioners, what we call Advanced Practice clinicians, or advanced practice practitioners, providers. We're going to see many more of them doing primary care, and a model that I think would would probably work very well is a team based model where the MD, who is kind of trained at a much higher level for many more years, leads a team of other providers made up of physicians assistants and nurse practitioners to do primary care, to take care of a group of patients, and perhaps that MD is there to consult, to be back up and to care for the more complex patients, while the nurse practitioners and PAs Are are getting the primary care, delivering the primary care.   Michael Hingson ** 17:23 Well, I know that the PAs that I have dealt with through the years, it seems to me, have, especially in the last 10 years, but have been very, very competent, very qualified. And I I don't, I don't know that, where I would say that they're less rushed, but I've had the opportunity to have some good conversations with them sometimes when, when the doctor just doesn't have the time. So it that's one of the reasons that prompted the question. It just seems to me that the more of that that we can do, and as you said, the more that that takes off. Perhaps some of the load from the physician itself may, over time, help the burnout issue.   Dr. Joe Sherman ** 18:10 I do think so. But I also feel like there's tremendous pressure right now on those pas and nurse practitioners, because they're under a lot of pressure too, too, and there aren't enough of them. Reduce and yes, so actually, right now, there's a movement within the the federal government to expand the number of positions in training programs for nurse practitioners and PAs. We have far too few, especially Physician Assistant schools. We don't have nearly as many as we need in this country. And if you look at the numbers, I think it's more competitive to get into PA school than it is to medical school,   18:54 really. Yeah,   Dr. Joe Sherman ** 18:58 I, you know, I that's been my experience of what I've seen from people just, you know, the number of applicants toward compared to the number of accepted, hey,   Michael Hingson ** 19:09 they wouldn't let you into a PA school, huh?   19:11 Exactly? Yeah.   Michael Hingson ** 19:15 No, I know. Well, it's, it is interesting. I know we read a few years ago that University of California Riverside actually started a program specifically, I'm trying to remember whether it was for training doctors. It was something that was supposed to be an accelerated program. Oh, some of the hospitals sponsored it. And the agreement would be, if you went to the school, you'd get the education, you wouldn't pay and at the end, and you would go to work for those hospitals like, I think Kaiser was one of the major sponsors of it. And again, it was all about trying to bring more people into the profession. Which certainly is admirable by any standard.   Dr. Joe Sherman ** 20:04 Yes, I think there are. Now, there are a few medical schools, and they're expanding the numbers that have free tuition, and they some of those schools, such as NYU Medical School has a generous donor who is given a tremendous amount of money as a donation and as an endowment. It pays for all the education of the students that go there. And there are some other schools that have the same arrangement. I think, I think if I were to be boss of the country, I would make all medical education free in in return, people would have to work in an underserved area for a certain number of years, maybe a few years, and then after that, they would be free to practice debt free, in any specialty and anywhere they would like.   Michael Hingson ** 21:10 Well, we need to do something to deal with the issue, because more and more people are going to urgent cares and other places with with different issues. I have someone who helps me a little bit. She's our housekeeper, and she also comes over once a week for dinner, and she has some sort of allergy. She just her face and her neck swelled up yesterday and had all sorts of red spots and everything. It's the second time she took not Benadryl, but something else that made it go away the first time, but it was back, and several of us insisted that she go to urgent care, and she went, and while she was there, she heard somebody say that they had been waiting four hours. So she left, you know, and which doesn't help at all. So I don't know actually whether she went back, because I talked with her later and said, Go back. So I don't know whether she did, but the waiting time is oftentimes very long, which is unfortunate. And I don't know whether more people are getting sick, or they think they're getting sick, or they're just taking ailments that are less too urgent care, but there are definitely long waiting times.   Dr. Joe Sherman ** 22:25 Yes, people, the people do not have a medical home. Many, many people don't have a medical home, a true medical home, that early in my practice pediatrician, as a general pediatrician, if there was a child that was in our practice and at night time or over a weekend, somebody would be on call. If that parent was concerned about a child in any way, they call the emergency line for the practice, the on call line, and that operator would page whoever the doctor was on call, and I would, as the doctor covering call that parent and talk directly at home, give advice over the phone, say what to do, make a decision of whether that child needed to go to the emergency room or not, or in the vast majority of cases, could give advice over the phone about what to do and then follow up when the office was open the next day or on the next week. Yeah, but nowadays, people aren't connected to offices like that. Yeah. We have call centers nurse advice lines of people that don't have access to medical records or have very strict protocols about what type of advice to give and the bottom line and the safest thing is go to the emergency room or go to urgent care. So that's unfortunately why some of the highest burnout rates are in emergency room doctors, and some of the biggest problems with understaffing are in emergency rooms right now. And   Michael Hingson ** 24:16 I can understand that, and makes perfect sense to hear that, and it's unfortunate but true. So yeah, but yeah, you're right. So many people don't really have a home. We've been blessed Karen, my now late wife, of course, was always a patient of Kaiser, and was a strong advocate for the way they did most of all of what they did. And so I eventually, when we got married and we were in a Kaiser area, then I did the same thing. And mostly I think it worked out well. I think. Kaiser is a little bit more conservative than some when it comes to perhaps some of the the newer procedures or newer sorts of things like they, you know, we see ads on TV now for the Inspire way of dealing with sleep apnea, as opposed to CPAP machines. And I don't know whether Kaiser has finally embraced that, but they didn't for the longest time. At least our doctor said that it wasn't really great to have to undergo surgery to deal with it, and the CPAP machines work fine, but I think overall it to to use your your words, definitely, if you're in that kind of an environment, it is a little bit more of a home, and you have definite places to go, which I think is valuable. And I think that more people really ought to try to figure out a way to find a home if they can.   Dr. Joe Sherman ** 26:00 Yeah, I do think that it is in the amount just society has advanced so so rapidly and so much in in how communication is instantaneous these days, through texting and through internet and through instant messaging, all these different ways that everything is sped up so people are looking for answers right away. Yeah, and it's, it's that's often puts too much pressure on the people that are trying to manage all of the patients that and all of their inquiries that they have. So I think, I think we need to make some serious changes in the way that we, that we staff hospitals, the way we staff clinics, and look and see what are the specific duties that need to be done, the specific activities and responsibilities in attending to a patient and specifically target personnel that are skilled in that activity, instead of having a physician who you know, is not the greatest typist, or is not the greatest at trying to figure out a code of billing for insurance or how to look at 100 messages that came in while she was attending to, you know, 25 patients in A clinic. It's just too much. It's overwhelming. And I mean, I now facilitate a group. It's a support group for physicians through physicians anonymous, where physicians are suffering from anxiety, depression, addiction. Suicide, ideation, and it's it's really at at scary levels right now, and I do think that the healthcare systems are starting to be aware of it. Think patients need to be aware of it, and the reason why, when you call, you're on hold forever or you never do get to speak to a real person, where it takes months to get in to see a doctor, it's because nobody's home. Yeah, everybody is many, many people have, have quit.   Michael Hingson ** 28:39 Yeah, there's such a shortage. I know at least we see ads oftentimes for nurses and encouraging people to go into the field, because there's such a shortage of nurses, just like there's a shortage of teachers. But we don't do as much with the conversation of, there's an incredible shortage of physicians. I think it's probably done in some ways, but not as publicly as like nurses and some other types of physicians.   Dr. Joe Sherman ** 29:13 Yes, I think right now, the I always feel like, I mean, this has been always true that on hospital floors, because the profit margin for hospitals is very narrow, there are only certain services that hospitals truly make profit on. So usually the staffing levels are kept to the very bare minimum, and now that just puts too much pressure on those that are remaining. And so now we're seeing many more hospitals have nurses that go out on strike or or decide to slow down, or. Or do other measures to try to get the attention of how dangerous it is to have understaffing in the hospital.   Michael Hingson ** 30:08 Have we learned anything, because of all the stuff that happened with COVID Now that we're in this somewhat post COVID world, have we have we learned a lot or any or anything, or is anything changing, and is there really ever going to be a true post COVID world? For that matter? That's a fair question.   Dr. Joe Sherman ** 30:29 That is a fair question. And I do think recent changes in policy by the CDC of of treating COVID As if it were influenza, or RSV or other type of respiratory viruses is there are many physicians that disagree with that policy, because COVID, this COVID, 19 that We've been dealing with, causes many more complications for those that have complex medical conditions, and this long COVID situation is something that we really don't have a grasp on at this point, but I believe one innovation I would see or expansion that has come about is the whole telehealth movement, now that there are many, many more video visits, I do think that's a good thing. I also believe that it can provide more flexibility for healthcare providers, which will help to decrease burnout, if providers are able to perhaps do their telehealth visits from home, or be able to spend time doing telehealth visits as opposed to having to see patients in person. I think what happens now is we need to get better organized as far as which types of visits are should be telehealth, and which types should be seen in person, so that one provider is not going back and forth from, you know, computer screen to seeing somebody in person, back and and so that gets too disorganized. Yeah, I think at times, other things, I think we learned a lot about infectious disease. I think that the general public learned a lot more about infections and infection control. I think that's all good. I think one thing that we did not learn, unfortunately, is how desperately we desperately we need to do something to try to stem the tide of burnout, because it just accelerated during COVID and then has continued to accelerate because of the economic crunch that healthcare systems find themselves in now.   Michael Hingson ** 33:10 Well, and what is, to me, a little bit scary, is all it takes is one COVID mutation that we don't expect or encounter, and we're almost in back where we were, at least for a while. And I hope the day will come when, rather than using the the mRNA type vaccine that we use now that we truly will have a vaccine like an influenza vaccine, that can really kill the virus and that we can then take, even if it's yearly, but that will truly build up the immune system in the same sort of way. Although I have no problem with the current vaccine, in fact, I'm going in for my next vaccine vaccination a week from tomorrow. And what cracks me up is I've been there a number of times, and some people talk about the conspiracies of all they're doing is injecting you with all these little things that are going to track you wherever you go. And I'm sitting there going, Fine, let them. Then if there's a problem, they're going to know about it, and they'll come and get me, you know, but what I really love to do is a nurse will come over, she'll give me the the vaccination, and she pulls the needle away, and then I reach over with my one hand and slap my hand right over where she did the shot. And I said, Wait a minute. One just got out. I had to get it, you know. And, and she says, you know, there aren't really any trackers. I said, No, I'm just messing with you, but, but you know, it will be nice when that kind of a vaccination comes, and I'm sure. Or someday it will.   Dr. Joe Sherman ** 35:02 Well, I think the vaccines it this specific, these types of respiratory viruses do mutate quite a bit. There's all kinds of variants, and they change every year. So I think no matter what kind of vaccine we get, we're still with with infections such as influenza or COVID, we're still going to end up needing to get annual vaccines, most likely, yeah,   Michael Hingson ** 35:34 and that is the issue, that even with influenza, we do get lots of variants, and I know a couple of years, as I understand it, they kind of predict what strains to immunize for based on like, when Australia gets in our middle of the year and things like that. But sometimes it doesn't work. That is they they guessed wrong when it gets to us, or it's mutated again, and it's unfortunate, but it is, it is what we have to deal with. So for me, as far as I'm concerned, anything that we can do is going to help. And I really have found the current vaccines that we do get for COVID, at least, whether it will totally keep you from getting it or not, which I gather it won't necessarily, at least it will mitigate to a large degree what could happen if you didn't take the vaccination.   Dr. Joe Sherman ** 36:34 Yes, yes, that's correct. We We are. We're seeing much less deaths as a result of COVID infection. However, in the peak of the winter time in the clients that I was that I've been coaching, who work in in hospitals and in ICUs, they were seeing still a large number of patients that were there. It's just that we've now developed better treatment and management for it and so, so then less people are dying of it. But it is, you know, we have, again, the amount of research, medical research and development that has developed these vaccines has prevented so much infection that what doctors are called on to do now and what they're called on to treat and manage has shifted much more into areas of behavioral health and lifestyle change than it is treating infections. That's dramatically different experience through my pediatric training than what type of training that a pediatrician these days gets   Michael Hingson ** 38:01 and there again, that means that the physicians have to spend the time learning a lot of that that they didn't learn before, which also takes a toll, because they can't be in front of patients while they're learning or while They're studying.   Dr. Joe Sherman ** 38:18 Yes, yeah, it's what the medical students and residents now are being called on to manage in the hospital are very, very complex, specialized conditions and very serious conditions. My experience as a resident was much more. The vast majority of people I took care of as a pediatric resident were normal, healthy children who happen to get sick, mostly with infection and sometimes very seriously sick, come in the hospital, receive treatment, and walk out as a child, a normal, healthy child again, we don't see that as often as pediatric residents, just speaking from pediatricians point of view, and I think that that has a an emotional toll on the resident physicians. I got a tremendous amount of reward from caring for patients with serious infections that received antibiotics and got completely better than patients who already have complex chronic conditions that just get worse or a complication, and they come In and the resident helps to manage them a little bit, and then sends them on their way. But really doesn't feel like they cured them contributed in the same way and that that was they don't have that same type of reward, that rewarding feeling, I think, are   Michael Hingson ** 39:59 we seeing? More of that kind of patient, significantly more than we used to in the hospital. Absolutely. Why is that? Is there really are more or   Dr. Joe Sherman ** 40:11 or what? Well, there aren't. We've taken care of most of the serious bacterial infections that used to be treated in the hospital with antibiotics, we've taken care of them with vaccines, and then we've also advanced the the quality and and variety of conditions that we can treat as an outpatient now, so that people that used to come into the hospital all the time for conditions, simple, basic things, are now treated as outpatients. And that's a good because you don't want to be in the hospital any longer than you absolutely have to. No,   Michael Hingson ** 40:58 I had, well, my father, I don't remember how old I was. It must have been in the we 1960 sometime he had to have a his gallbladder out. So it was a pretty significant operation at the time, because they he was in the hospital a couple days, and came home with a nice scar and all that. And then my brother later had the same thing. And then in 2015 suddenly I had this, really on a Thursday night, horrible stomachache. And I figured there is something going on. I hadn't had my appendix out, but this wasn't right where my appendix was, but we went to the local hospital. We called Kaiser, and they there isn't a hospital, a Kaiser hospital up here, so they sent us to another place, and they took x rays, and then we ended up going down. They they took me by ambulance on down to Kaiser, and it was a gallbladder issue. So I guess all the men in my family had it. But what happened was that when they did the surgery, and by the time we got down to Kaiser, the there was a gallstone and it passed. So I didn't want to do the surgery immediately, only because I had the following Sunday an engagement. So we did it, like a week later, the doctor thought I was crazy, waiting. And then later he said, Well, you were right. But anyway, when I had the operation, there were three little band aids, and it was almost, I guess you call it outpatient, because I went home two hours later. Wow, I was I was blessed. So they it was almost like, and I've had colonoscopies before. I didn't spend any more time doing the gallbladder operation than I did, really, with all that I spent in the hospital doing a colonoscopy, it was pretty good,   Dr. Joe Sherman ** 42:58 right? I do think that there's been again, major advances in endoscopic surgeries and robotic surgeries and minimally invasive procedures to be able to to treat patients. I mean, again, I have to say that our ability now to treat stroke and and heart attacks, myocardial infarction, our abilities to our ability to treat those acutely, do something to try to improve the outcome, has improved dramatically just recently, I would say, especially stroke management. So what we have is amazing, dramatic changes in in reducing the morbidity and mortality from stroke now, and I think that it's remarkable. Even as a physician, I didn't even realize until a recent trip I took to Bolivia with a group of neurosurgeons how stroke is treated now, and it's, it's, it's phenomenal that before you have a stroke, and it's just kind of like, well, you hope for the best. You support hope that some blood flow returns to that part of the brain. Now, if you have a stroke, and people are taught to recognize it and immediately get to the hospital, they can give a medication to melt the clot, or actually go in there with the catheter and extract the clot out of the vessel and restore you back to full function and   Michael Hingson ** 44:56 remarkable, and have a glass of red wine while you're at it. Yeah. Uh, or, or, do we still say that TPA helps some of those things a little bit? You   Dr. Joe Sherman ** 45:07 know, it's interesting. It's, you know, as far as as I think I've never seen so many articles written about the consumption of alcohol coffee, going back and forth and back and forth. You know what's helpful? What's not? Everything in moderation, I would say this point,   Michael Hingson ** 45:28 yeah, I I would not be a good poster child for the alcohol industry. I have tea every morning for well, with breakfast. And the reason I do is that I decided that that would be my hot drink of choice. I've never been a coffee drinker. The caffeine doesn't do anything for me, so it's more the tea and then a little milk in it. It is a hot drink. Ever since being in the World Trade Center, I do tend to clear my throat and cough more, so the tea helps that, and that's the reason that I drink tea. But I remember seeing old commercials about red wine. Can can help you. So if I have a choice in wine, I'll oftentimes get red just because I've heard that those commercials, and I don't know how how true it is anymore, but hey, it's as good a reason as any to have a glass of wine every other week. And that's about what it usually is.   Dr. Joe Sherman ** 46:26 Yeah, sounds like. Sounds like a good, a good plan. Yeah,   Michael Hingson ** 46:31 works. Well, it's, it's now kept me around for a while, and we'll keep doing it. It works. So what is it that healthcare workers and physicians do to kind of restore their love for what they do and work toward burnout? What can individuals do?   Dr. Joe Sherman ** 46:54 I think we're at a point now where in in approaching the issue of burnout and approaching the issue of overwhelm with the amount of work that physicians are called on to do these days is a combination of personal Changes to mindset and approach to our work, as well as structural and organizational changes to facilitate our work. And I think that the organizational structural changes, again, have to do with trying to improve specific staffing to match the activities and responsibilities that are that are called on in the medical setting, and being able to do more in the in the formation of medical teams and in teamwork And in people having a common mission, working together, appreciating what each other does, and hospital administrations and and those folks that run the business of the hospital truly value and enlist The engagement of frontline workers in policy and procedures. So those are kind of structural changes right on the personal side, yeah, I was that's I just a lot of it has to do with being more realistic. And I'm speaking to myself too. We can't do everything for everyone all the time we are human. We often have been taught that we are super human, but we're not. And if, if we try to do too much and try to do it perfectly, then our bodies will rebel and we'll get sick. So I think we need to set boundaries for ourselves. We need to be able to say, these are the hours that I'm working. I can't work any more than that. We need to say that you can't reach me three different ways, 24 hours a day, all the time, and have me respond to all of those inquiries, we have to set limits, and we have to really look at what it is that we love about medicine, what it is we love to do within medicine, and really try the best we can, I Think, with the help of coaches and other types of mentors and folks that can help us to create the types of jobs and the types of positions that help us maximize that experience of fulfillment, that experience of of. Feeling like we truly are contributing to the health and well being of our patients. Do   Michael Hingson ** 50:07 you think overall that the kind of work you do, and then others are doing to address the issue of burnout is is really helping? Are we are we making more progress, or are we still losing more than we gain.   Dr. Joe Sherman ** 50:23 I think we're making progress on an individual basis, on people that do seek help. But we need also to change the mindset of ourselves as physicians, to be willing to seek help. We need to seek help and be admit that we need that type of support, but until we get organizational commitment to trying to change the structures and the systems that we work under, then we will continue to have more physicians lost to burnout, depression and suicide.   Michael Hingson ** 51:05 Are healthcare institutions recognizing more the whole issue of burnout, and are they? Are they really starting to do more about it?   Dr. Joe Sherman ** 51:17 Some, I think some are. I think organizations are recognizing it. Associations of physicians are recognizing it. But when it comes to surviving as a health organization, healthcare institution, the bottom line is, what runs a show, and the way you make income is through billing, and the billing occurs as a result of a health care provider providing and billing for what they Do. So if there's an economic crunch, the first thing to go is anything that doesn't generate income and supports for the well being of staff does not generate direct income. What it does, though, is that it retains staff. It it results in a happier staff, a more higher professional satisfaction, and in the long run, is going to save you money,   Michael Hingson ** 52:33 yeah, which, which is another way of making some more money.   Dr. Joe Sherman ** 52:39 Yeah. I mean the total cost, the average cost for replacing a physician who has decided to quit is anywhere from about 600,000 to $2 million depending on the specialty of the physician. Yeah,   Michael Hingson ** 52:57 and then getting people to necessarily see that is, of course, a challenge, but it still is what what needs to happen, because it would seem to me that those costs are just so high, and that has to account for something that is still a fair chunk of money. Yeah, it   Dr. Joe Sherman ** 53:16 is. It's a great deal of money. And, you know, our again, our system of health care, we were headed in the right direction. And I think eventually we have to get there to population based health in looking at health outcomes and trying to look at overall health of of our our citizens and and those who live here in our country in trying to, instead of having a fee for service model, have a model that looks at reimbursement for health care based on the total health of The patient, and that is contributed to by nurses, doctors, technicians, receptionists, community health workers, all those types of health professionals.   Michael Hingson ** 54:12 What can we do to get the wider society to become more aware of all of these issues and maybe to advocate for change.   Dr. Joe Sherman ** 54:25 I think, I think avenues like this, these   Michael Hingson ** 54:29 podcasts, this podcast is one.   Dr. Joe Sherman ** 54:32 I also believe that look at your real life, lived experience of trying to access healthcare today compared to how it was 20 years ago, and are you having more trouble? Are you having is it more expensive? Are you having more challenges? This is direct result of a. System that's not functioning well.   Michael Hingson ** 55:02 Did the whole process of what we now call Obamacare, did that help in the medical process in any way? I   Dr. Joe Sherman ** 55:11 think what happened with Obamacare was well, and the bottom line answer is yes, it has helped. And the way it has helped is that more people have access to health insurance, less people are completely uninsured than ever before. So I think from that perspective, that's been helpful, but there were so many compromises, oh yeah, to insurance companies and two different lobbyists that were all looking out for their interests, that what ended up happening was a much more watered down version of what was initially proposed, but step in the right direction, And if we continue to work toward that, and we have some contribution of government sponsored health insurance, then we're going to be better off as a nation,   Michael Hingson ** 56:14 yeah, well, and anytime we can make a step forward, it does help, which is, of course, a good thing. So if there's one thing you want listeners to take away or watchers, because we are on YouTube, if there's one thing you want people to take away from this, what would it be?   Dr. Joe Sherman ** 56:33 It would be, pay attention to your own personal experience with healthcare. Pay attention to your own health and observe what's going on in the clinics, in the offices and in the hospitals where you receive your medical care. If somebody is treating you well with respect and compassion, point it out. Make it known. Thank them. Yeah, make it known that you know that they're under tremendous stress and pressure, and that anytime that they can be kind, then that means that they are very dedicated to to treating you, treating patients. And if you're finding that where you're going to receive your health care seems to be understaffed, and say something about it. If you have a health care provider who is a bit snappy, is not patient with you, doesn't seem to be listening to you, it's not because they don't want to. Yeah, they desperately want to. It's just that the conditions are such that they're not able to   Michael Hingson ** 57:44 and and it would probably be good to at least engage them in a little dialog and say, hey, hey, I'm not trying to yank your chain here and kind of try to help warm them up. I've been a firm believer that in a lot of places where I go, like in the in the airline world, the TSA people and so on, I love to do my best to make them laugh. So like when I go up to the kiosk and the TSA agent says, I need to see your ID, especially when I'm wearing a mask, I'll say, Well, what do you want to see it for? You can't tell who it is behind this mask, right? And I've had a couple people who didn't expect anything like that, but they usually laugh at it. Then the other one I love to use is they ask for my idea. I say, Well, what's wrong with yours? Did you lose yours? And I just love to try to make them laugh where I can, because I know it's a thankless job, and I know that what doctors and medical people deal with is a pretty thankless job, too. So it's fun to try to make them laugh whenever I can and get them to smile.   Dr. Joe Sherman ** 58:47 Yep, they all could use a little bit more humor. Yeah, there's always that. So   Michael Hingson ** 58:51 if people want to learn more about you and reach out and learn about your work and so on, how do they do that? Where do they find you, online or any of those things? Sure,   Dr. Joe Sherman ** 59:00 I have a website that you can go to. It's Joe Sherman md.com and you can reach me by email. Joe at Joe Sherman md.com also on LinkedIn, so you can find me there. Too Cool. Well,   Michael Hingson ** 59:20 once again, I want to thank you for being here. This has been a lot of fun and very enjoyable and in a lot of ways, but certainly educational, and I've learned a lot, and we got through all the questions this time that we didn't get through last time, which is always a good thing. So see, it was worth doing it twice.   Dr. Joe Sherman ** 59:39 Great. Thank you so much. Well, it was   Michael Hingson ** 59:42 fun, and of course, for you listening out there, reach out to Joe, and I want to hear from you. I want to hear what you think of today. So please email me. Michael, h i at accessibe, A, C, C, E, S, S, I, B, e.com, or go to our podcast page, www, dot. Michael hingson.com/podcast and Michael Hinkson is m, I, C, H, A, E, L, H, I N, G, s, O n.com/podcast, would really appreciate a five star review from you, wherever you are listening to us. We like those reviews if you can, if you know anyone that you think ought to be a good guest on unstoppable mindset. And Joe you as well. We'd love to hear from you or provide us introductions. Always looking for more folks to to meet and to chat with, and love the incredible diversity and subjects that we get to talk about. So that makes it a lot of fun, but I do want to just once more. Joe, thank you for being here. This has been enjoyable, and I really appreciate it. Thanks   Dr. Joe Sherman ** 1:00:40 so much, Michael, I enjoyed the conversation.   Michael Hingson ** 1:00:48 You have been listening to the Unstoppable Mindset podcast. Thanks for dropping by. I hope that you'll join us again next week, and in future weeks for upcoming episodes. To subscribe to our podcast and to learn about upcoming episodes, please visit www dot Michael hingson.com slash podcast. Michael Hingson is spelled m i c h a e l h i n g s o n. While you're on the site., please use the form there to recommend people who we ought to interview in upcoming editions of the show. And also, we ask you and urge you to invite your friends to join us in the future. If you know of any one or any organization needing a speaker for an event, please email me at speaker at Michael hingson.com. I appreciate it very much. To learn more about the concept of blinded by fear, please visit www dot Michael hingson.com forward slash blinded by fear and while you're there, feel free to pick up a copy of my free eBook entitled blinded by fear. The unstoppable mindset podcast is provided by access cast an initiative of accessiBe and is sponsored by accessiBe. Please visit www.accessibe.com . AccessiBe is spelled a c c e s s i b e. There you can learn all about how you can make your website inclusive for all persons with disabilities and how you can help make the internet fully inclusive by 2025. Thanks again for Listening. Please come back and visit us again next week.

Looking at my 2024 whiteboard, some of my goals will go unchecked.   → But my clients crushed theirs. → Making the big bucks → Landing huge 15/10 roles   All while overcoming ageism   → Building new networks to last a lifetime → Leading companies and changing industries → Lifting others up without a second thought.   I've described it as the year of EVERYTHING.    And you top the list.  You've listened You've shared You've subscribed and written reviews.    THANK YOU!  I strive to continue to bring you new guests that honor your time Challenge your mind And reframe your thinking.    This week we'll keep it short, with key takes from 13 this year's most listened to episodes.    Full episodes are here:  Your First Step On LinkedIn I Jasmin Alic  Awkward? Good! | Henna Pryor Time Rich? Energy Poor? | Simon Alexander Ong How To Become Unignorable I Communicate Like 1% of CEOs I Oliver Aust How To Be A Likeable Badass And Why It Matters I Alison Fragale The Universal Ism, Ageism I Dealing With It In Your Career (Pt 1) I Maureen Clough Copy For C-suiters, Words That Win Jobs I Adam Knorr Storytelling IS Everything I Michael Margolis Find Your Unique Voice (Even If You Think You Lost It) I Melissa Cohen & Julie Michelle Morris What's The Difference Between Culture Fit & Culture Climate? I Dr. Colleen Saringer You're A Legend In the Making: Secrets to Executive Transformation I Howie Chan Soothing Lies: Debunking Self-Care Fairytales I Randi Braun Mindfulness In Your Career Is BS | Steve Ware   Follow me, Loren Greiff on LinkedIn Book a call with me

Stuck in holiday traffic? Make the most of your travel time with our curated collection of student loan resources perfect for your commute. We'll explore the latest Pay As You Earn (PAYE) rumors, tackle tricky PSLF payment count challenges, and share a simple yet effective tool to estimate your IDR forgiveness progress while we wait for the Department of Education's much-anticipated tracker. Key moments: 02:41 New resources you'll love: Podcasts for dentists, physicians, and veterinarians 05:36 How to pinpoint your payment count if you're curious where you stand on forgiveness 14:11 Nearing 120 payments? Don't miss this step-by-step guide we've been sharing with our clients 28:23 PAYE might be making a comeback: The pros, cons, and what it could mean for you 
Links mentioned:  PSLF payment tracker through StudentAid.gov https://studentaid.gov/app/api/nslds/payment-counter/summary Financially Free Dentists podcast Financially Free Physicians podcast   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning   Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

It's an unlikely scenario, but the possibility of President Trump abolishing the Department of Education in his second term is a hot topic that's sparked questions and concerns among student loan borrowers. We'll explore what that might mean, unpack the fears and anxieties expressed by our listeners, and provide context around the policy implications. Plus, stick around for our “listener mailbag,” where we tackle specific questions and worries that have been pouring into our inboxes.  Key moments: 04:31 Republicans' plan is not actually to eliminate the Department of Ed 10:21 How to handle income recertification for IDR plans during job gaps 16:04 Will the discontinued PAYE plan return amid changes? 22:37 Timing actions around the 0% interest period for student loans Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning   Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!

In this comprehensive episode of Finding Financial Freedom with The Frugal Physician, Dr. Disha Spath hosts Travis Hornsby, founder and CEO of Student Loan Planner, to explore the current landscape of student loans and repayment strategies for high-debt professionals. With over $800 million in student loans consulted on, Travis is an authority on loan repayment and shares crucial insights on navigating Public Service Loan Forgiveness (PSLF), recent policy changes, and strategies for repayment that every physician, professional, and student loan borrower needs to know. Discover how changes in student loan policies under the Trump, Obama, and Biden administrations have reshaped the repayment landscape and what potential policy shifts could mean for borrowers in the coming years. Travis also discusses methods to optimize PSLF eligibility, the pros and cons of refinancing, and the best strategies for long-term financial freedom despite student loan debt. Key Topics Covered: Travis Hornsby's Journey & Student Loan Planner's Mission Travis's background in finance and bond trading at Vanguard, his journey to starting Student Loan Planner, and why he's dedicated his career to helping borrowers navigate complex student loan systems. Public Service Loan Forgiveness (PSLF): From Inception to Transformation How PSLF has evolved since its inception in 2007, including challenges under the Trump administration and impactful changes introduced by President Biden. Changes in Income-Driven Repayment (IDR) Plans Overview of the original income-driven repayment options (PAYE, REPAYE, IBR, ICR) and how Biden's new SAVE plan replaced REPAYE with enhanced interest subsidies. Potential Pitfalls & Common Mistakes in Repayment Plans How to avoid costly missteps when selecting a repayment plan, including considerations around PSLF qualification, income certification, and timing of tax filings. Navigating Political and Legal Challenges in Student Loan Policies Insights into current legal challenges to the SAVE plan and potential impacts of future policy changes on IDR options for physicians and other borrowers. Refinancing vs. Forgiveness Travis outlines when it's beneficial to refinance your loans versus staying on a PSLF track, with practical advice for borrowers based on debt-to-income ratio and financial goals. Resources Mentioned: Student Loan Planner for calculators, tools, and professional consultations. Travis's Books: Managing Your Money in Your Twenties and Thirties and 25 is the New 65: How to Retire Outrageously Early. Listener Takeaways: Gain a better understanding of student loan repayment plans and forgiveness options. Learn the strategies for managing student loans amidst political upheaval and legal challenges. Understand when refinancing makes sense versus sticking with PSLF or other forgiveness options. Connect with Us: Host: Dr. Disha Spath, The Frugal Physician Guest: Travis Hornsby, CFA, CFP, Student Loan Planner Follow us on Instagram, Facebook, and Twitter for updates on upcoming episodes. Thank you for tuning in! Be sure to share this episode with anyone navigating student loan repayment.   This episode is sponsored by: PearsonRavitz– Helping physicians safeguard their most valuable assets.  This episode is also sponsored by FacetWealth– Discover how Facet is transforming financial planning for physicians with personalized, flat-fee financial planning—visit facet.com/frugalphysician to start building your financial future today.

With Trump's unexpected victory in the popular vote and key swing states, and a likely Republican majority in Congress, significant changes to student loan policies may be on the horizon. We'll look at possible shifts in Public Service Loan Forgiveness (PSLF) that could make it harder to qualify, and the potential elimination of the Saving on a Valuable Education (SAVE) plan. We'll discuss recent court rulings that could reshape repayment strategies, like the 8th Circuit Court decision on the Income-Contingent Repayment (ICR) statute. We'll also touch on political dynamics influencing these changes, including Republican and Democratic strategies, the implications of past proposals like the Prosper Act, and what borrowers need to consider moving forward. Key moments: 04:18 Likely elimination of the SAVE plan — when should you consider switching to a different repayment option? 08:27 Republicans are making their own IDR plan and how past proposals threatened borrowers 18:42 Loan forgiveness potential might be more generous than we think 24:22 Potential for major policy changes under Trump's second term   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning   Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!  

After a LONG hiatus, I'm back for a special episode of Alter Your Health.In this episode, I/Dr. Ben share...How I healed from a "chronic illness"The insights and learnings from the healing processUpdates from Alter Health and what's ahead in 2025The future of the Podcast (?)The latest from the new venture, Vis Foods+ moreSome links referenced:Breathwork practice - https://www.youtube.com/watch?v=mVchZ8D15EcTMS Free Life Program - https://www.alter.health/tms-free-lifeGREEN FORCE! - www.visfoods.co (use the code AlterYourHealth for $10 off)Links to more good stuff- EAT MORE, WEIGH LESS PROGRAM - www.alter.health/eat-more-weigh-less- 1-on-1 Nutritional Analysis Package - www.alter.health/nutritional-analysis - Get the Alter Health weekly WFPB Meal Guides: www.alter.health/meal-guides- Thrive on Plants Program: www.alter.health/thrive-on-plants- TMS Free Life Program - www.alter.health/tms-free-life

Kiera and Britt are joined by Dr. Renae Sweeney, a dentist in South Florida who put in a lot of work to make her practices stand out. The three discuss how she was able to effectively find her client base, the importance of staying confident in your goals, and more. Episode resources: Follow Dr. Sweeney on Instagram! Reach out to Tiff, Britt, and Dana Tune Into DAT's Monthly Webinar Practice Momentum Group Consulting Subscribe to The Dental A-Team podcast Become Dental A-Team Platinum! Review the podcast Transcript: Kiera Dent (00:00.862) Hello, Dental A Team listeners. This is Kiera and today is just a super fun day. I have two people on here today. I have Dr. Renae Sweeney. You may have seen her on social media. You may know Rafiki. You may know her birds. You may just see her as one of the funniest people on Instagram. And we have the one and only No BS, Stone coming on today. I'll start with Britt. How are you doing today, Britt? Welcome.   Britt (00:24.645) I mean, I'm great. I'm excited to be here. I love when you share my nicknames now with clients since Dr. Sweeney is one of my clients that I get to work with. So you're welcome, Dr. Sweeney. Now you know what my nickname is.   Kiera Dent (00:31.874) Ha ha.   Kiera Dent (00:35.244) you   Dr. Renae Sweeney (00:36.044) Yes, I love it. love it. No, super excited to be here with you guys. Thank you. Thank you.   Kiera Dent (00:39.221) And dr. Sweeney welcome. Yeah, we're so excited Like I love you. I don't know as much about you because Britt has worked with you guys for so many years you and Soon to be hubby, right soon to be   Dr. Renae Sweeney (00:49.033) Yes, yes.   Dr. Renae Sweeney (00:54.355) No, he's so is that it's actually a little bit confusing. So we've actually been married for three years, but we are finally doing our wedding this year. So I know it's like a little bit confusing because yes, we're we're having our wedding actually in six weeks. Funny enough. But yes, we've been married for three years already, which is crazy.   Kiera Dent (01:02.249) Okay   Kiera Dent (01:09.398) That's amazing. Okay, so married we've been like Britt has worked with you and your husband we can now say husband but like wedding that's exciting. That's gonna be so fun. So I thought it'd just be fun to like bring both of you on. I want to know all about your bird like everybody I think I want to know some about your social media. But I thought it'd be really fun for you and Britt to kind of go on like a little walk of like how you guys were how you guys met Britt told me that she loves working with you and   Dr. Renae Sweeney (01:17.706) Yes.   Dr. Renae Sweeney (01:30.73) Mm -hmm.   Kiera Dent (01:35.82) Dr. Molina because you guys are truly like a dynamite couple. You're willing to try everything. You guys have grown so much. You've gone from one practice to two practices looking for a third. So Britt, I'm going to kind of let you like jump in and guide and navigate on some ways too. But really, I think it's just going to be fun of like, let's go on like a walk down memory lane of what are some of the things you guys have done to get to this level. And Renae, you're so fun. Like you're so happy and so vibrant and yet you guys have a lot going on. So I will kind of turn it to Britt.   Dr. Renae Sweeney (01:36.64) Yes.   Dr. Renae Sweeney (01:43.478) Mm -hmm. Mm -hmm.   Dr. Renae Sweeney (01:58.923) Thank   Kiera Dent (02:02.348) Have fun, let's do a little walk down memory lane and of course I'm gonna interject because I'm gonna have a ton of questions.   Dr. Renae Sweeney (02:06.879) Yeah.   Britt (02:07.97) Well, the fun thing of the walk down memory lane, I think is that I worked with Dr. Molina first, right? And one location and Dr. Sweeney, you were still, think, working somewhere else, right?   Dr. Renae Sweeney (02:14.547) Yes.   Dr. Renae Sweeney (02:20.489) Yeah, so when we when we bought the first practice, I was still working actually like at a corporate office. So I've kind of been in my background, worked for a nonprofit, worked for private practice, worked for corporate offices all before I like we bought a second location, which is the location that I'm mainly at. So yes, you did start with kind of like him on the side. So I was like in that but kind of indirectly in it. But yes, so which is crazy, because I think it's been like over three years now, which is wild.   Kiera Dent (02:49.068) I just remember calling Dr. Molina one day. Like we were just having a conversation. He's like, what on earth? Amazon just threw a package in our pool. Like that was literally like the conversation I had with him and it feels so telling of his personality. You guys are in Florida. You're in a very saturated area, which I love because you found success in a saturated area, but you've been behind the scenes. You bought a practice that was mostly Spanish speaking and I'm sure your Spanish was like not quite there yet. So.   Dr. Renae Sweeney (03:00.545) Yes.   Yes.   It was.   Dr. Renae Sweeney (03:11.73) Yes. yeah.   Kiera Dent (03:15.33) That's a fun, like, hey, let's treat these patients and not even be able to sell to them. Cool. So anyway, Britt, keep going. I'm excited. It's like fun things about both of you. Very entertaining couple for sure.   Dr. Renae Sweeney (03:19.282) Yes, yes.   Britt (03:26.565) They are 100%. I love them. And I love that now I get to work with both of them. Because once we had practice number one, when practice number two came into play, that's when Dr. Sweeney and I got to connect a little bit more to where I got to start working with both practices and her one -on -one. Sometimes I get to see both of them when we like hop on calls together and they're in the same place. But it's been fun having second location. know they've got big dreams and aspirations, which I think Dr. Sweeney can tell us a little bit more about. But I do.   Dr. Renae Sweeney (03:33.563) Okay.   Dr. Renae Sweeney (03:41.799) Mm -hmm.   Britt (03:55.525) love working with them because I think you both were pretty clear on where you want to go from the beginning, right? Like, you know where you want to go practice wise. Dr. Molina has been big on making sure we get all the systems into play. So like, know we're going to be doing this more. So let's make sure we've got things in play. And then it's been fun because now you've got another practice that you're working on. You've transitioned, stabilizing, agreed with Kiera. It's like you're in an area where, you know, you know that there's competition and you guys are creative and get out there. And Kiera, I'll add.   Dr. Renae Sweeney (04:00.391) Thanks.   Dr. Renae Sweeney (04:06.812) Mm -hmm. Right.   Dr. Renae Sweeney (04:22.362) Mm   Britt (04:24.975) I know that Dr. Sweeney is working on her Spanish, so like, who's getting there?   Dr. Renae Sweeney (04:27.336) Yes, it's funny because now I'm like, have patients now who like have stayed with the practice, know, since prior to me purchasing or acquiring the office till now. And I just had a patient the other day who was like, my gosh, you're like, you're doing so well. Like you sound like you're fluent in Spanish now, which I am by no means like actually fluent. But yeah, it's I always tell people I'm like, careful what you wish for. Because I always used to say like years ago,   Kiera Dent (04:28.608) Hola!   Kiera Dent (04:48.589) you   Dr. Renae Sweeney (04:53.841) before I ever really knew like where I would end up or how things would be. I was said that I wanted to learn Spanish more and I was like, be careful what you wish for. Cause I got exactly what I wish for unknowingly with it. But yeah, so it's, it's been a work in progress, but it's awesome. I love it. And it's, as you said, it's a very unique area that we're in South Florida and like Miami, like as a whole is just very, very different. And I think the unique part about learning Spanish here, I was so impatient. This is that it's not just one type of Spanish because you have people who are from Venezuela,   Kiera Dent (05:02.056) Hahaha   Dr. Renae Sweeney (05:23.736) Puerto Rico, Colombia, Cuba, like you have so many different dialects of it. So for me, I have to like learn a word like six different ways in Spanish, but my patients are awesome about it. My staff is bilingual and awesome about it. So like they've helped me so much. And it's something that like, it's just another like challenge that I get to take on, but it was definitely like a big challenge having to overcome as a new dentist coming out, buying a practice and finding out like.   Kiera Dent (05:32.778) you   Dr. Renae Sweeney (05:49.358) in the process of it that it was such a heavily Spanish speaking practice as someone who is not fluent in Spanish and really at the time didn't really speak Spanish at all. But I think it just goes to show that if you're willing to put in the effort and the time, how much you really can, what you can do and the challenges you can overcome and really, it's just so much, so many things are possible if you're just willing to take the time and learn and dedicate towards it.   Kiera Dent (06:14.744) So like dive into that a little more for me, Dr. Sweeney. I am dying to know like, what do you guys do differently from your perspective? Obviously like with Britt's help and with different things you guys have done, like what do you feel has been like some key pieces to your success or how do you get that grit? Cause I think a lot of people would have been like, I'm not signing on the dotted line on this practice or I'm going to give up on this. Like it's a saturated market. It feels like you don't allow yourself excuses. So kind of walk me through like, what are some of the things that you feel have really set you guys up to be as successful as you've been?   Dr. Renae Sweeney (06:21.391) Mm -hmm.   Dr. Renae Sweeney (06:35.907) Right.   Dr. Renae Sweeney (06:43.906) Right. So in the process of ours, it was definitely unique. Like you don't know what you don't know. Right. So, I mean, even in the process of getting that office, there were so many things that we were still learning. Because yes, we already had one practice on our belt. But again, every practice acquisition, every practices, it's just different. You're dealing with different owners, sellers, brokers. Like there's just so many different key parts that are.   It's different in every single deal and even that we're seeing as we're looking for a third practice now. So we really didn't know up until right before closing, basically, most of our documents and things were kind of said and done that we found out that it was portrayed to us that it was, there was obviously Spanish speaking patients, which is just a very normal thing in South Florida across the board. Most places that you work at, they want you to be bilingual. that was, I figured that was, we were gonna have that, but it wasn't until really closing that we found out.   out that it was such a high majority of the office was Spanish speaking, which   I remember after we met with the owner that day, because it was different in this deal that we didn't really meet the owner until at the very end. So more or less, unfortunately, the broker kind of misled us a little bit. again, this is, you know, just comes with I'm sure you guys have seen a lot with just different practices, you deal with different people. Right. So I remember we went home after that meeting and we kind of looked at each other and we're like, what do we do? You know, and I remember I was very panicked because I'm like, I don't I'm not fluent in Spanish. Like, should we do this? Should we not? You know, and then we kind of ultimately made the decision that we're like, you know, it's   a good opportunity. You I'm willing to learn the Spanish, like all of the staff is bilingual. And for anybody who's from South Florida, they will know that like Miami versus where we are in Broward County, it's about 30 minutes like north.   Dr. Renae Sweeney (08:25.076) Yes, you have patients who speak Spanish, but it's slightly different. There are patients who know more English. It's just a little bit different environment. So was like, I think we can navigate it. think we can do this. And I had said, I always wanted to learn Spanish more. I was already kind in the process of trying. So was like, you know what? This is going to be my push that it's sink or swim. Like really, it truly is. And that's how it is with owning your own business, having your own company, your own office. Is that way anyway, that it really is like sink or swim. Like you have to just learn how to figure it out. And I was like, okay, this is just another challenge. We're going to take it on. So definitely, I think we made it a little bit   harder for myself in the process, but long term I'm super grateful for it because like I said, it's just a very unique environment that we get to be in. I get to be a part of a community that...   is different from what I grew up with, is different from what I, you know, was a part of before. And it was something that I wanted to be a part of and wanted to understand more about. And I just love it. My patients have been super great in the process of like, I've never had anyone be upset with me of getting something wrong. If anything, I think they like try to help me more with learning. And they're like super proud when they come back and they're like, my gosh, you're doing so well with your Spanish. You're able to do this. And for me, I always tell people like, sure, could I get away with not speaking Spanish and relying on my staff? Absolutely. But like for me,   Kiera Dent (09:30.05) I   Dr. Renae Sweeney (09:37.854) personally that was a big thing because i'm like then i now lose a different level of connection with my patients and again i know people who do that i came from an office where the per se owner didn't speak spanish and we were in a very predominantly spanish speaking area so you can definitely get away with that but for me i was like you know i don't want to lose that aspect of it and i know that it's something that like i can do again it's just   have to dedicate the time and effort will i ever be at that point where i'm fully fluent probably not at this point hopeful that like we can get close but you know i think it's just one of those things that like when you really are willing to set your mind to it and have a vision for what you want and how you want things to be like you'll just do what it takes to get there no matter how long it takes because more than anything i'm like now we're i'm   little bit more than two years into this office. And I'm like, time is going to go by no matter what. like, if I keep taking steps forward and keep dedicating the time and effort, whether that's to learning Spanish, whether that's to our systems or, or to, you know, the vision that we have for these offices, like you're going to get there eventually. And before, know, like, it might not be as fast as I want it to be, but it's   when you look back in time, like you get there and then for other people, they're like, my gosh, this happened so fast, you know, so we oftentimes, I think things feel with progression. I'm sure you guys can even feel that way, you know, with your own businesses is that progression sometimes feels a lot slower to us as we're in it and we're doing it day to day. But you know,   in the long run when we look at other people, it's easy to think that success happens so fast for them. So very long -winded response of all of that. But all that is to just say is that's how I think we try to look at everything with our practices, is that just taking steps forward and towards our dedicated goal every single day, you're gonna get there eventually, and you just have to stick with it, knowing that things are gonna be up and down with stuff, but just stick towards it, and you will get there.   Kiera Dent (11:03.776) Mm -hmm. I like it.   Kiera Dent (11:16.842) Mm   Kiera Dent (11:22.594) Totally. Yeah, no, think kudos to you. I think that shows like your guys' entrepreneurial spirit, the grit. And I just had a conference and Tony Robbins said, people overestimate what they're going to be able to accomplish in a year and underestimate what they're going to be able to accomplish in a decade. And I really think that that's lovely because I think so many people, it's hard. Like you can think like, I'll be fluent in Spanish in a year, but like maybe in a decade, you're actually going to be super fluent within this.   Dr. Renae Sweeney (11:28.537) Mm   Dr. Renae Sweeney (11:38.555) Yes.   Dr. Renae Sweeney (11:45.357) Mm -hmm. Yeah   Kiera Dent (11:50.402) And like, look how far you've come in two years and this patient base, but also like looking at your, which I didn't really give into your bio of like you were a previous bar fit, hit fitness instructor. You taught classes throughout dental school. Then you taught it while you were in your first practice. You also are a former D1 dance team. You have your degree. You have like three Instagram accounts. So it's not just one, but three. And I'm sure with every other child and animal or whatever you choose to add to your life.   Dr. Renae Sweeney (11:52.475) Mm -hmm.   Dr. Renae Sweeney (12:04.827) Mm -hmm.   Dr. Renae Sweeney (12:18.247) Mwahahahaha   Kiera Dent (12:19.778) They'll probably have their own page too. But I think also like some people might look at that and be like, my gosh, she's her. But I'm like, no, what I love about you and the reason I wanted you on the podcast is because I feel like you have this grit and determination, but I feel it's because you have this guiding star of where you want to go. How did you get so clear on your vision of where you wanted to go? Like, was it just innate? Did you say like, this is the goal we're going for? Did you unravel, be like, all right, this is what our life's going to be? How did you get so confident on your goals of where you're headed?   Dr. Renae Sweeney (12:31.587) Mm -hmm.   Mm -hmm.   Dr. Renae Sweeney (12:46.544) Yeah, I that's a great question and side note, I'm like the quote that you said with Tony Robbins is super funny because I actually just put up a post I think like a day or two days ago and I used that in the caption as well. Like the first time, like when I heard that I was like, this is so good. And I actually didn't even realize it was from Tony Robbins, but side note, so that was really funny. Yes, but it's so true, so true. No, it's such a good question. So I think on a lot of different fronts, like if someone had asked me years ago, like I...   Kiera Dent (12:55.681) Hahaha   Yes.   There you go. Now you know. He said it literally at the conference. So there you have it.   Kiera Dent (13:12.12) you   Dr. Renae Sweeney (13:12.963) never thought I would move to Florida, let alone have a monkey, a golden conure, like have multiple practices. So like, I cannot say this is like from a young age, like where I thought I would be, but I think, but a couple of different things, I think for sure, you know, Dr. Molina, give him so like, Raul, I give him so much credit for a lot of things because he truly is.   like such an entrepreneur through and through. And him and I always talk about it. I truly believe that that was like a God given gift for him. So for us, like at the end of the day, our faith is like super, super ingrained into every single thing that we do. So he has a very good vision that we have, you know, has been implanted in him and that we have worked on together and kind of always are continually talking about revisiting.   Where we want things to be where we like see our practices where we see our life where we see different things heading and at the At the base of it. We always say that you know, we have these goals. We have these things in mind But we always come back to like God where do you want us to be? do you want us to land? What is this supposed to look like for us and we very much like follow in accordance to that so like it's truly been a blessing that we've been able to do all that we have and like where we're at in life and we're super super grateful and thankful for it and we always just say that you know, like   whenever we think we want to head towards, like we start aiming and heading towards that. And if it doesn't work, like we know we're going to get turned around and we're going to head back to like the other direction that we're supposed to be in. But yeah, it's something that I think we always keep revisiting that at the core of it. We always say like our mission and our vision for just our offices is that we really want to change the way that people think about going to the dentist and give them an excellent experience across the board. And what that can look like can be super different. I came from a background where   from a young age, it was always very instilled in me of really having a servant's heart of being a part of mission trips, and which, know, throughout high school, college, dental school, and even now, I've been a part of a lot of nonprofit organizations, mission work locally and internationally, and really just at end of the day, it's because we enjoy helping people, and I think a lot of dentists and doctors go into the field for that reason.   Dr. Renae Sweeney (15:21.078) And that's always stayed kind of at like the root of it is that for us, like truly helping people and in dentistry, know, yes, we're treating teeth, we're treating oral health issues, but at end of the day, like you're treating humans. And I think if we can keep that at the, for us, if we can always keep that at the core of what we're doing, like we're always going to strive to create like this great experience for people, no matter what that looks like, because, you know, we're treating a person, we're finding out their story, we're creating that connection. And I think that's what's super important and allows us to   Kiera Dent (15:43.0) Sure.   Dr. Renae Sweeney (15:51.272) no matter how much things might change as we're going throughout time that always keeps us rooted in where we want to be and in what that looks like is because we're always coming back to that and what our true mission and vision is. And that being said, through that, whether it's two practices that we have or a dozen practices or what locations we're in, all of that are, I think, to...   Kiera Dent (15:59.936) Mm -hmm. Totally.   Dr. Renae Sweeney (16:19.457) to our vision in all of that. that's something that like, yes, we always just come back to and we try to keep at the core of it. But, you we do monthly meetings, we do weekly meetings with our staff to always continue to check in to see like, okay, this is where we want to be. Like, are we heading towards that? Are we taking steps towards it? Because it's very easy to say like, this is my dream. This is what I want to accomplish. But if you don't have natural check -ins and things that, you know, we're constantly revisiting or even, you know, meetings with Brittany where we're...   Kiera Dent (16:34.52) Sure.   Dr. Renae Sweeney (16:44.949) you know, on a monthly basis, always checking in, like, how are things going? Like, is this where we want to be? What do we need to do to get there? Because if you're not, it's very easy to completely veer the other way. And then you get over here and wonder, how did I get over here when really I wanted to be over here? Right. But it's like, you have to constantly take steps and do those check -ins to evaluate, like, am I actually taking steps closer or farther away from where we're trying to end up?   Kiera Dent (17:07.41) Exactly. No, and I'm so glad you said that. And I actually, I want to actually pivot to Britt because I think so many people have visions and they're lofty and they're like excited and gone home. What I love about you is it does feel core. It feels like this is your core. You want to serve people. You want to help people. You guys have such entrepreneurial spirit, but I think like entrepreneurial spirit without systems and check -ins is pure chaos. So I'm super curious to Britt as a consultant who's watched this incredible dynamic couple grow.   Dr. Renae Sweeney (17:22.346) Mm -hmm.   Dr. Renae Sweeney (17:29.546) Mm -hmm. Great.   Kiera Dent (17:36.738) What are some of the things you've seen that maybe they've done very successfully from a bird's -eye view, right? Dr. Renae, let's just have her be the amazing report card of how great you guys have been. But what has been some of the things you've seen that have set them up for success that maybe other practices aren't doing that's controlled that entrepreneurial spirit into predictable systems and consistency? Because I really do believe they've got the core and the heart. I know they've got systems backing it as well.   Britt (18:02.787) Yeah. And I think that's one piece that Raul and Renae, I think we're super solid on, even when just Raul and I were working from practice number one, that we were, the two of us were super light. And he's like, I want systems in this first practice. Great. We want to get that. And he's like, we want to get this dialed in because then we knew from the get go that they were going to take those and go duplicate at other practices that that was their ultimate goal. So we wanted to get practice number one running really well, getting things to work great. We know our   How are we scheduling appointments? Are we collecting deposits? How are we talking to patients about it? What's our verbiage? Scheduling, he's really good at comprehensive treatment planning. So making sure that we've got that down and making sure all the pieces were in plain functioning in that practice number one, before they went to more practices, which I'm like is super smart for those wanting to go into multiples. Because often people will like, well, great, let's just like start going and buying more practices and start kind of.   getting out there and going where we want to go and make it happen fast. And that's one way to do it. But it can start to become too much chaos when, well, this practice isn't doing well. Well, how are we doing things across the board? So I think just with, you know, Renae's vision and where they wanted to go and being so intentional about where they're going, they were also intentional in how they got practice number one set. So then they could go and keep doing it in other practices. And Renae can   probably speak to, right? Then being the doctor that comes into practice number two, having those systems to be able to support it. And she's done a great job of transitioning things over there, working with her team, growing as a leader to where like now when they're ready for that next practice or the next practice after that, they've got the two of them and they're awesome supports of each other. see them cheer each other on all the time to then, you know, keep going and keep building and keep spreading all the great things that they're doing for their patients.   Kiera Dent (19:58.754) That's love hearing that because, and Renae, I'm coming to you next on this, that is so hard as an entrepreneur. Like I give our story of we bought our first practice and nine months later we bought our second. That was pure freaking pandemonium and we were psychotic. And I tell everybody, that's why I built a consulting company is to have you not learn like the hard way like we did. How have you guys been able to like curb that? Like you have been in this practice for, I think you were saying two, maybe almost three years before you're about to buy a third.   Britt (20:03.845) Okay.   Dr. Renae Sweeney (20:19.184) Mm -hmm.   Dr. Renae Sweeney (20:24.889) Okay.   Kiera Dent (20:27.618) But like that's dedication and discipline that I think a lot of entrepreneurs don't have. So how have you guys been able to like, is it like you guys keep each other in checks and balance? How do you do that? Is it that you've got Brittany who like keeps you like on the straight and narrow? Like what is it to help you guys really be dedicated and disciplined rather than chaotic and out of control chasing a vision?   Dr. Renae Sweeney (20:30.245) Mm -hmm.   Dr. Renae Sweeney (20:47.621) Yeah, I mean, I think it's all of it, you know, it's because I think it's very easy to get just completely out of control, get overwhelmed. Because at the end of the day, like there is with having your own business, whatever field that isn't or no matter how many dental offices you have, like there's just always things to be done, right? There's always more that can be done. There's always like it's just always endless, right? But you have to like learn how to keep it in check. You have to learn when to shut it off, have boundaries with things. So, yeah, I mean, even just between him and I, like we   Kiera Dent (20:51.32) Thank   Dr. Renae Sweeney (21:16.896) as you said, like we always share each other on we're always like talking about, you know, how we can better things and just even with our staff to like, that's why we do these monthly meetings. That's why we have these different things in place. So that way, you know, they see things from a different view than we do. And I think that's a super important thing as an owner in any capacity is like, your staff is a vital part to your growth, you know, like, sure, I can sit there at the end of the day and say, this is my practice, you know, I'm in charge of things and you know, whatever, which yes, that's true. But   Also, like if I can rely on my team and continue to build them up because at end of the day, you can continue to build so that you're building up people to be to a higher level, like through and through, and like you're building up leaders, you're automatically gonna thrive and grow because you're just gonna continue to grow and expand as people are able to step into higher positions, take on more responsibility to be able to delegate things more. So I think us always just being able to   really like with the meetings with Brittany, on our own time, like having these points where we're always looking at like, okay, how can we get better? Like, what did we do well? What can we improve upon? How do we keep pushing this forward and always keeping those visions in mind of what we're trying to achieve and through the way, like along the way realizing like...   we would love to get it all done at once. And I think as dentists, we're like, or dental professionals, like we're very type A, most of us that we want like everything done perfect and everything done, you know, as quick as possible, but like, that's just not always the reality, right? So you have to have like kind of your highest priorities, like how this needs to happen and then work from, from there. Otherwise, I it can get super chaotic because I, I know even for us, even having the systems we have in place, it's very easy that to look at something and be like, my gosh, I need   all of this stuff done, I need it all done right now and it all needs to be perfect and you just like can't like you're going to overwhelm yourself and it's going to be like mass chaos with things versus if you can like tailor back in you know the things that are the most important that we really need to focus on and get those like systems running and in place knowing that like we always talk about it roland that like running business i think it's like kind of like juggling like you're always throwing one ball up in the air and other ones are coming down and like we're talking back up and i'm sure britney if i have talked about this many times as well that it's like   Kiera Dent (23:03.82) Yes.   Kiera Dent (23:25.527) Mm   Dr. Renae Sweeney (23:30.125) know people like including ourselves we we progress and we regress right and like that's always going to happen and i think knowing and understanding that it makes you better able and better equipped to deal with everything that comes along but yeah so for us with having so we bought the first office in 2021 bought this one in 2022 so it was about like a year and a half between when we got that one when we got this one and now we're looking at a third office so it has been a couple years now if you ask us like   Kiera Dent (23:50.584) Thank   Dr. Renae Sweeney (23:57.996) Sure, we would have loved to have a third office sooner, things to move more quickly. But at the end of the day, I truly believe that things happen for a reason in accordance with a plan that if it did happen faster, we would get the downside of now you're dealing with so much more before we're totally ready for it. And sure, are you ever going to feel 100 % ready? No, because that's just not how it works. But it has been a blessing on that side that the bright side is we've had more time to put more systems in place to   Kiera Dent (24:16.054) you   Dr. Renae Sweeney (24:26.685) get some of our staff that's been with us more established, more comfortable with things. So that way, when we get a third office, we have more key players in place that it's much, much easier to take those systems, push it over to the other practice and have some of our staff over and help them to be able to be more acclimated to how we do things within our brand and within our offices and bring them into the culture that we're already building. So I think the beauty in having more time between that is that you're able to better establish your systems and your culture.   Kiera Dent (24:26.996) Mm   Dr. Renae Sweeney (24:56.267) Which is really hard because I think Brittany and I have talked about it before that it's like that can really make or break your office right if you don't have a good culture and a good system in place sure you can be the best doctor in the entire world, but like That's that's gonna. It's kind of come to a head right you're gonna be the bottleneck in all of that So it's super super important more than anything like that. Yes, you want to be a great doctor You want to have those services, but like you want to be such a good leader that you're continuing to bring up other people You know into these positions their understanding system so that way you can basically like   pick up and plug anybody into those positions, build them up to be leaders as well and have a type of culture where it's like people are comfortable and excited about what's being built within it because they feel really a part of something.   Kiera Dent (25:37.89) Totally. I love what you said. And I love that you guys, you're so driven on goals and where you want to go, but you're also very realistic with life. And you're realistic of not trying to force a plan, but to live in the plan. And then refining and seeing the blessings and the joy within all of it. And I think that that's a beautiful perspective that not a lot of people have.   Dr. Renae Sweeney (25:45.257) Mm -hmm.   Dr. Renae Sweeney (25:51.956) Mm -hmm.   Dr. Renae Sweeney (25:58.15) and   Dr. Renae Sweeney (26:04.788) Yeah.   Kiera Dent (26:04.952) I know you guys are so busy. And so I'm to bring you back on Dr. Renae because I'm dying to know about how you became the influencer you became starting social media in 2023 because so many people are like, if you didn't catch the wave in 2020, then you might as well kiss it goodbye. And I think you are walking proof of that. But today I just appreciate you and Britt coming on and talking about your practices, talking about your vision, talking about your entrepreneurial spirit. You bring so much love.   And I love how much you love your team. love how much you love the path. I love that you love grit and determination and like we have in our saying, Britt knows we have a core value called grit and it says like challenges fire me up and I live for breakthroughs. And I feel like you embody that. Like challenges do fire you up and all these like you don't see them as big stumbling blocks. Like, yeah, I'm going to climb this freaking mountain. I'm going to learn Spanish. I'm going to take this on. We're going to do this. And I think to hear a doctor   Dr. Renae Sweeney (26:44.477) Good   Dr. Renae Sweeney (26:50.675) Mm   Kiera Dent (27:01.782) just like other doctors be able to do that is beyond amazing. So I'm so appreciative of your time. I know you are such a busy doctor. So we're gonna bring you back, because I need to know all about your parrot and your monkey and your social media, because I'm dying to know all about that. But are there any last things as we wrap up today that you wanna add to anything that's been said today?   Dr. Renae Sweeney (27:13.363) Yeah.   Dr. Renae Sweeney (27:21.252) say and I think this leads into like what we can talk about next time is I think more than anything it's just like your consistency with things no matter what you're doing whether it's social media or your office or any of that is like I always tell people I'm not the most creative person there is nothing special about me and like what I have done or what you know we're trying to accomplish it's just the ability to be consistent and all that because I think through and through your hard work and your consistency is what's going to carry you through you can be you know they always talk about it with sports like you can be the most talented person but at end of the day someone who works harder and is more consistent is going to surpass   that person at some point in time and I think it's so true with anything so whatever you know whatever you're trying to do or whatever you know your goals are you know with your offices or or in your personal professional life just knowing that like if you really stick with it and dedicate the time and effort and knowing that like being consistent is not just a couple weeks or a couple months it's like   months and months and months or years and years worth of dedicating discipline and continuing to come back to that, like that you really will get and I think not just get to where you want to be but surpass where you want to be through that because at the end of the day, I think your discipline and your consistency matter just like so much to it and your dedication to the process of what you're trying to build and be a part of.   Kiera Dent (28:12.855) Yeah.   Kiera Dent (28:31.48) Brill, like I'm writing that up on here. Brilliant. I love it. Thank you so much. Britt, we'll just wrap up quickly with you. Any last thoughts you've got about Dr. Renae, Dr. Raul, things you've seen, anything you want to add to this as we wrap up today.   Dr. Renae Sweeney (28:33.562) Yeah.   Britt (28:45.379) Yeah, I think the only last thing I'll add, I love them. They're amazing. I think they also do a lot to feed themselves, which I think can be tough for entrepreneurs too. I love hearing about trips they take, places they go. They still do a lot of things with friends, right? And do things outside and go take trips. And so I think that's another piece of like, she is, they are amazing people and they have the dedication, they have the consistency. Like they have that drive of being an entrepreneur, but   They are very dynamic humans. There's a lot of other things that they do as well, which I think is part of what makes them so successful is because they have all of those pieces, family close by, family farm, all the things that make life fun and exciting along with being an entrepreneur.   Kiera Dent (29:27.264) Amazing. I love being someone who doesn't know you as well as Britt does, but to just see also the relationship you two have together of how much Britt knows about you and how much you guys have used each other and just the beauty that you guys have. And honestly, Renae, you guys are the couple that I'm like always rooting for. I want successful people like you to win. I want you guys to be the most successful and the most flourished because I know you're just doing good in this world. So thank you for being on the podcast today. Thank you for your time.   Dr. Renae Sweeney (29:37.764) you can take.   Dr. Renae Sweeney (29:45.431) Thank you.   Dr. Renae Sweeney (29:53.181) Thank you. I appreciate you having me. Thank you. Thank you   Kiera Dent (29:56.812) Of course and don't worry everybody I will have her back to like learn all about the socials so everybody this is Dr. Renae and Britt and all of you listening I hope you guys take notes from them learn from them follow her go like watch her and then stay tuned because we'll have her back and as always thanks for listening and we'll catch you next time on the Dental A Team Podcast.  

In our latest episode, I (Dr. Karen Litzy) was honored to be interviewed by my good friend Dr. Stephanie Weyrauch after receiving the prestigious Robert G. Dicus Award at the APTA Private Practice Annual Meeting. This award recognizes lifetime achievement in private practice, and I couldn't be more grateful for the support from my colleagues and mentors throughout my journey. Join us as we discuss the impact of mentorship, the importance of finding your voice, and the lessons learned along the way. Time Stamps:  [00:03:26] Robert G. Dicus Award. [00:04:20] Dicus Award recognition. [00:09:23] Finding your voice journey. [00:12:36] Overcoming public speaking fear. [00:19:30] Learning from negative experiences. [00:21:18] Business ownership mindset shift. [00:24:47] Authenticity in professional settings. [00:30:31] The importance of a support network. [00:32:21] Healthy, wealthy, and smart life.   More About Dr. Karen Litzy: Dr. Karen Litzy, PT, DPT is a licensed physical therapist, international speaker and owner of Karen Litzy Physical Therapy, PLLC. Through her work as a physical therapist, she has helped thousands of people, including Fortune 500 CEOs, royalty, and celebrities, overcome painful conditions, recover from surgery, and feel more vital than ever before. As the host of Healthy Wealthy & Smart, a top 200 podcast on Apple Podcasts, she has interviewed health, medicine, and entrepreneurship influencers. She also shares how she has prevailed with her own experience of chronic pain. As a keynote and featured speaker, Dr. Karen has addressed thousands at national and international events, including Columbia University in New York City, the University of Colorado in Denver, and the International Olympic Committee World Conference on Prevention of Injury and Illness in Sport in Monaco. Karen's expertise has been featured in magazines, podcasts, TV Newscasts, and websites, including Prevention, Martha Stewart Living, Wirecutter from the New York Times, Time Magazine, The Washington Post, and more. She is a member of Prevention Magazine's medical Review Board. She lives in New York City.   Resources from this Episode: Tricia Brouk Robert G. Dicus Award   Jane Sponsorship Information: Book a one-on-one demo here Mention the code LITZY1MO for a free month   Follow Dr. Karen Litzy on Social Media: Karen's Twitter Karen's Instagram Karen's LinkedIn   Subscribe to Healthy, Wealthy & Smart: YouTube Website Apple Podcast Spotify SoundCloud Stitcher iHeart Radio

Imagine a world where the SAVE plan is struck down by the courts, taking various income-driven repayment (IDR) plans with it and leaving millions of borrowers scrambling. This worst-case scenario could block hundreds of thousands from accessing Public Service Loan Forgiveness (PSLF) and introduce massive complications for those on IDR plans. But don't worry, I'll break down this doomsday scenario, discuss its implications, and offer strategies for how you can best prepare. Highlights from this episode: 02:37 Tougher eligibility for PSLF and income-driven repayment 06:33 Key tax strategies (reducing AGI, filing separately, and community property considerations) 09:36 Why I'm not overly concerned just yet 16:51 How to make sure you can still get a spot on the IBR plan   Like the show? There are several ways you can help! Follow on Apple Podcasts, Spotify or Amazon Music Leave an honest review on Apple Podcasts  Subscribe to the newsletter Feeling helpless when it comes to your student loans? Try our free student loan calculator Check out our refinancing bonuses we negotiated Book your custom student loan plan Get profession-specific financial planning   Do you have a question about student loans? Leave us a voicemail here or email us at help@studentloanplanner.com and we might feature it in an upcoming show!