YFP 327: Pharmacy Innovators with Dr. Natalie Park (Pharmesol)


On this segment of the Pharmacy Innovators, sponsored by Pyrls, Pharmesol co-founder & CEO Dr. Natalie Park joins host Dr. Corrie Sanders.

Episode Summary

With the rise of AI and the increasing use of technology in our daily lives, there is an opportunity to improve the pharmacy world and patient care. On this segment of the Pharmacy Innovators sponsored by Pyrls, Dr. Natalie Park, Co-founder and CEO of Pharmesol, joins host Dr. Corrie Sanders, to discuss how Pharmesol leverages technology and AI to optimize patient communication and follow-up care. Natalie shares her unconventional career path, what Pharmesol is, what inspired her and her co-founders to start it, and how it is improving patient care. She also discuss the highs and lows of starting a business before delving into the importance of value-based care, what pharmacy will look like in the future, and how we can embrace the inevitable technological changes.

About Today’s Guest

Dr. Natalie Park is a pharmacist with a background in conducting health economics and outcomes research in the pharmaceutical industry. Natalie is co-founder and CEO of Pharmesol, an automated and proactive medication assistant tool that leverages pharmacist expertise and artificial intelligence to enhance patient experience after direct interaction with the healthcare team.

Key Points From the Episode

  • Introducing Natalie Park, co-founder and CEO of Pharmesol. 
  • Natalie tells us about her studies and unconventional career path in pharmacy. 
  • The inspiration behind the creation of Pharmesol, what it is, and how it can be used in clinical practice. 
  • How Pharmesol leverages AI. 
  • The accelerator program Natalie and her co-founders did to start the business. 
  • Where she met her co-founders and how their skills differ from Natalie’s. 
  • Where Natalie was in her personal and professional life while developing Pharmesol. 
  • What she thinks pharmacy will look like in the future and how we can adjust to the technology. 
  • Natalie shares the most memorable events of her pharmaceutical career. 
  • Her favorite parts of being an entrepreneur and why she enjoys being in charge of her career.
  • Natalie shares advice for anyone contemplating a non-traditional career path.

Episode Highlights

I’m a pharmacist, but that doesn’t mean I know every single thing about every single drug.” — Dr. Natalie Park [0:06:52]

“Starting a company is really difficult. It has been very difficult. Not to say [you should] not pursue it. I do think it is a decision that takes a lot of consideration.” — Dr. Natalie Park [0:25:33]

“I’m bullish on healthcare moving towards value-based care.” — Dr. Natalie Park [0:31:11]

Links Mentioned in Today’s Episode

Episode Transcript

[INTRODUCTION]

[00:00:00] CR: Hi, YFP community. Corrie Sanders here, host of the Pharmacy Innovator segment of the YFP podcast. Pharmacy Innovators is designed for pharmacist navigating the entrepreneurial journey. In this series, we feature founders’ stories and strategies that help guide current and aspiring pharmacy entrepreneurs.

Today, I talk to Dr. Natalie Park, a pharmacist with a background in conducting health economics and outcomes research in the pharmaceutical industry. Natalie is co-founder and CEO of Pharmesol, an automated and proactive medication assistant tool that leverages pharmacist’s expertise and artificial intelligence to enhance patient experience after direct interaction with the healthcare team. We will discuss having honest conversations with yourself and others surrounding risk tolerance and career change. And dive into Natalie’s bullish stance on value-based care and the untapped potential within the pharmacy profession to impact health outcomes alongside technology. I know you all will be nothing short of inspired by Dr. Natalie Park.

[SPONSOR MESSAGE]

[0:01:02] JW: This is Justin Woods from the YFP team with a quick message before today’s show. If you’re tired of relying on shared passwords, or spending hundreds of dollars for drug information, we’ve got great news for you. Today’s podcast sponsor, Pyrls is changing the game for pharmacy professionals. Pyrls offers top drug summaries, clinical teaching points, a drug interaction checker, calculators, and guideline reviews all-in-one, user-friendly resource. They also recently added a free weekly quizzes to test your pharmacotherapy knowledge. Whether you’re on your web browser or accessing the mobile app, Pyrls has got you covered. Visit pyrls.com. That’s P-Y-R-L-S .com to get access to more than 25 free pharmacotherapy charts to get you started. Upgrade your drug information resources today with Pyrls. Don’t miss out on this game changing resource.

[INTERVIEW]

[0:01:56] CS: So Natalie, we are so excited to have you on the YFP podcast this morning. We will start with a really easy question of how you got into pharmacy and where you went to pharmacy school. So just tell us a little bit about your pharmacy background.

[0:02:10] NP: Yes, sure. I went to Ohio State for pharmacy school. So I actually came to the states when I was 15. I didn’t speak much English at the time, and I’m not even sure if I had insurance, to be honest, because I was an international student. So I was young, so I don’t think I knew kind of much what was going on with insurance and medical side of things. One day, I remember getting this allergic rash, which I’ve never experienced before in my life. Then I kind of freaked out, and then I went to the pharmacy. Then I showed the pharmacist kind of my rash, and then I remember asking like, “Oh, what am I supposed to do?” And then they helped me out. So that was kind of one of the reasons that inspired me to go to pharmacy school, and I went to Ohio State for both my bachelor’s and pharmacy school.

[0:03:05] CS: Love it. So firsthand experience threw you into the profession. Tell us about a little bit of your training after graduation. So you’ve kind of been on a non-traditional career path, it seems. Since graduation, you’ve done a lot in industry, so tell the listeners a little bit about that path and some of the jobs that you had, or residency training, or postgraduate training after graduation.

[0:03:27] NP: After pharmacy school, I did an industry fellowship in health economics and outcomes research. I had already taken some statistics, and epidemiology classes while I was in pharmacy school, and had some internship experience. Then my post-doc fellowship was at University of Maryland, as well as Novartis. So I did develop budget impact model, cost effectiveness models, when there is a new drug launch to take to payers, as well as using EHR and claims data to do comparative effectiveness research. Then, I went to a health system called Geisinger. First, I worked in their innovation department doing vendor assessment of digital health companies, developing internal business cases, as well as implementing subpopulation health solutions. Then I had an opportunity to move to their pharmacy department where I worked with different service lines, urology, dermatology, primary care, these different departments on the topic of medication management and optimization.

[0:04:38] CS: Wow, that is amazing. So quite a different career paths than I think the average pharmacist would probably think of when they think of one of the options within the profession. So it’s amazing, I mean, you’re working with big organizations just right out of the bat with really high-level thinking with outcomes and clinical decision support tool research, it seems. So kind of a broad-based business knowledge, just based on your years of experience in these innovation departments and working really from just a high-level perspective point of view. I’m sure you took a lot of things away from your previous job experience when you shifted into Pharmesol.

Tell us about the development of Pharmesol. Was there a certain situation where something happened and this business model came to light? Where did the inspiration from the business come from?

[0:05:30] NP: Yeah, I think if I think back, it was few different experiences coming together. Because I was working with the pharmacy team and different clinicians at a health system about the topic of medication management. I just naturally were thinking a lot about medication management, and how can we really improve the status quo, like that was my job. One of the things that I found challenging was that my colleagues, even though they were really motivated to help their patients, because they knew how much help their patients needed, but they didn’t have a lot of time. So that sort of became a challenge over and over again, in different implementation processes.

So I just had this realization and thought in mind that like, wow, the clinical capacity, lack of clinical capacity is such a problem. This may not sound that insightful, but I think it’s really different if you experienced this yourself, like every day, and this is kind of what I’m fighting against every day. So I had that thought on one hand, and then I actually had a poor experience as a patient myself. I always tell people, I’m a pharmacist, but that doesn’t mean I know every single thing about every single drug. I went to a doctor and then got some medication and I didn’t get any instruction about how to use it from the doctor or the pharmacists where I picked up the medication. And then, I came home, and I was like, “Wait, actually, I have a question.” Then I was like, “Wow, this like really sucks.”

Then the third experience is, like kind of during this time, I was – I’ve actually been working on masters for computer science. So as part of this, I built a recommender system. This is kind of the engine that drives kind of personalized recommendation that you experience in Amazon or Netflix. That kind of really made me think about my experience as a consumer, outside of healthcare is actually pretty good. I feel like these systems know me, knows what to recommend for me. I mean, apart from recommendations, just my experience as a consumer. So why can’t we do that in healthcare, is another thought that kind of – that I was having, and a combination of these different thoughts was a big motivator and I think kind of origin story for Pharmesol.

[0:08:20] CS: That’s wonderful, kind of not a three-pronged approach, but certainly three different tiers to the approach and the development of the company. Tell us, and know that you’re talking to an audience of pharmacists that intimately understands the pain points of the profession. What is Pharmesol, and how can it be used in clinical practice? Kind of break that down for us.

[0:08:43] NP: Yes, Pharmesol is a conversational AI. It’s an automated and proactive medication assistant, that enables healthcare organizations to provide high-quality, personalized support for patients through SMS text messages. So the experience for the patient is a little bit like maybe talking to a pharmacist to some degree about like calming counseling points, right? Like, “Hey, I missed a dose. What do I do?” or “I don’t know how to use this injection.” We’ve been working with a primary care clinic, where we white-label this solution. So patients when they get up, medication prescribed at the clinic. After they leave, we send a text message to say, “Hey, have you been able to pick up this medication?” Then, patients either say yes or no, and a lot of patients say no for a variety of reasons. 

Then, we help them troubleshoot. “Okay, tell me more what is the issue.” Some patients are like, “I’m just waiting for delivery” or we have some patients say, “Wait. What? I didn’t even realize I was supposed to be taking this medication.” So that’s kind of an opportunity for med rec, or another patient who said, like, “Oh, actually, I lost a third bottle of my pills, so I haven’t been taking it.” Except, that patient didn’t reach out to the clinic, or the doctor, and they – but they weren’t taking it, and they only told us because we proactively asked this question. So we help them troubleshoot, and then give them education, and then patients also have a line of communication where they can ask questions.

[0:10:24] CS: So kind of really expanding upon the preferred mechanism of communication for a lot of patients, which is text messages. But instead of just saying, “Hey, your prescription is ready.” It’s really taking it to the next level of different counseling points, and making sure it’s a comprehensive follow-up process, and putting this all in the palm of the patient through a text message. So what’s happening on the end of Pharmesol, just so that people can get a complete picture from the consumer standpoint? And then what’s happening behind the scenes? Is this a live-generated chat? Are we using an integration of AI and different mechanisms of literature analysis? What’s really going into the output that the patient ultimately receives?

[0:11:11] NP: Yeah, we’re leveraging AI, and also, we’re training this to say, “Okay, this is the accurate information about this medication, and this is not.” Essentially, don’t lie, don’t make things up.” So how we do that is we hire currently practicing clinical pharmacists to develop our content and what it can say. That is why, of course, it cannot, of course, replace humans, as mentioned, like it can answer, “This is the storage instruction” or “This is how you can use the information” or ask follow-up questions of, “Okay. What is kind of challenging for you?”

Then we also ask questions like, “Have you missed any doses?” What is kind of the reason you missed these doses?” These are the information that pharmacists are looking for to be able to make medical decision making. Okay, maybe this dosage form is right for them or not, or they’re struggling with this. So this is kind of further education, “I want to give” or “I want to have further conversation.” 

But instead of them kind of taking the time to ask these questions, we have the conversation with patients. And then we bring those actionable insights to pharmacists, so then they can really do the high-cognitive task, and make this medical decision making, and then make any adjustments to the treatment, if necessary.

[0:12:46] CS: So really streamlining to use a clinical skill set and a clinical knowledge base, and then leaving the lower-level questions, so to speak to the AI tool. Am I understanding that correctly?

[0:12:59] NP: Yeah, yeah. I think another advantage is, unfortunately, there’s just limited clinical capacity. What I see today happening is, some patients get a lot of support that they need, some patients get no support. I guess, sort of – as relatively healthy, young kind of person as me, pharma health system or the clinic, like the pharmacists are not likely going to reach out to me and ask, “Hey, Natalie. How are you doing? Are you nauseous? Are you feeling dizzy?” I’m not going to kind of be the type to get these questions. 

What our solution enables healthcare organizations to do is actually provide this high-quality care to every single one of their patients, and do the follow-up. We can tell the pharmacist, hey, this patient is doing just fine. So you actually don’t need to reach out to them, but this other person has an issue that requires your attention. So this is how we can increase the quality of care for really every patient, at the same time increasing the efficiency for pharmacists.

[0:14:18] CS: Sure, meeting the patient where they’re at, and then directing the support where it’s needed the most. When did you have this idea, and when did you transition full-time into working with Pharmesol? What did the development look like of the company for you?

[0:14:33] NP: I don’t know. I think I had a lot of different thoughts. I don’t really think there was like one point I was like, “Oh, this is the idea.” Even as I said, I just had different thoughts in the back of my mind. Kind of, “Oh, yes. I think this could be better. Why is it like this? Is this all we can do?” But that doesn’t mean I really thought like, “Oh, I should start up company.” It was like a really – it’s a pretty common moment for a lot of people where you feel like, “Oh, this really sucks.” 

Then, I think it kind of accumulates, compounds, and actually, even what I thought might be kind of a viable business idea in the beginning was not exactly what we’re doing today. But I think what really helped solidify what we’re currently working on was really the feedback of other people, like other pharmacists, other doctors, other nurses, administration, the administrators at health plans, health systems, pharmacy benefit managers, pharmacies. Our team reached out to these folks and ask them, “Hey, what do you think is kind of like an opportunity area? What are problematic and challenging for you guys?” Because I understand – I don’t know, I guess, like, I’m just one person, like one health system just because I think this is a problem, and this is a good idea. That doesn’t necessarily mean other people see the value. So I think it was just through organic interactions. Some organic, some were actually – we reached out to them to learn these insights. I think through that is how we got to where we are today.

[0:16:36] CS: Sounds like a good organic amount of some kind of market analysis and trying to figure out a product market fit for where this kind of technology can really provide the most value. Did you go through some kind of accelerator program or a business development program? Or how did you really hone in on trying to figure out where you are today, and ultimately, what is this end product going to look like? What kind of steps did you take to get to this point?

[0:17:07] NP: Yes. We actually pretty recently completed an accelerator program, a startup accelerator program. It’s called Entrepreneurs Roundtable Accelerator NYC, ERA NYC. My team, I have two co-founders. We’re first-time founders. Starting a company, founding a company, isn’t something we’re used to. There’s a lot of questions, and problems that you’re faced with that you never really had to think about in a corporate setting. I think going through this accelerator program was really helpful from that perspective because there are a lot of mentors, who are previous startup founders, current startup founders, or operators who’ve sort of like really thought about innovation, and developing a new product bringing into market. We definitely learned a lot from being part of this accelerator program.

[0:18:13] CS: Certainly, the aspect of you don’t know what you don’t know, and we’re trained with such a small clinical skill set, especially when you decide to pursue a specialty. I mean, there’s so many aspects of business, and I feel like that’s where a lot of YFP listeners want to start something new or have a new idea. It’s not the pharmacy component that’s the most intimidating. It’s the finances, and the business acumen, and getting funding, or getting your foot in the door with the market. That becomes so overwhelming, much faster than the pharmacy component does in most cases. I can see how an accelerator program is absolutely a great way to make you a well-rounded competitor in a space where you just don’t know what you don’t know, for the most part. So Natalie, you mentioned you have two co-founders. How did you meet these people? Where did you cross paths? Then, what skills do they bring to the company that are different than your own?

[0:19:11] NP: Yes. I’m really lucky to have two software engineers as my co-founders. Saumya is one of my co-founders, software engineer by training. She studied computer science at MIT for her bachelors and she was doing Master of Engineering when I met her. She has a lot of experience applying AI in healthcare in particular. She’s always had a lot of interest in healthcare, so that’s really helpful. Batman is our CTO, also software engineer by training. He had worked at multiple startups, building from scratch. Then he also recently graduated from MIT from Masters of Systems Design and management program. 

I didn’t even necessarily work in a – not even necessary. My work experiences in pharma and health system, I think are really crucial to what we’re doing at Pharmesol. I actually don’t think I could have started Pharmesol if I didn’t work at those healthcare companies, and learned what does the dynamics look like, what do each healthcare stakeholder kind of looked for? But again, the different – in some sense, actually, developing a product I don’t think is that different. I actually think every person in any role is probably developing some kind of product and like looking for a product market fit. But not – I wasn’t in kind of a traditional tech environment. I actually wasn’t even familiar with concepts of like Sprint, how do we use a Jira to do like task of tracking project management.

They definitely bring a lot of expertise from technical and product development perspective. I actually think our team is definitely –one of the strengths of our team, kind of our unique is composition of skill sets and backgrounds, I think is one of the strengths for Pharmesol.

[0:21:43] CS: Definitely. I mean, it sounds like you have an all-star lineup of people that specialize in areas that you don’t. So you become a well-rounded team pretty quickly, which is really important to success in the long run, I think. That’s really so great. I want to highlight something that you said, Natalie, which I think is really important, and maybe will resonate with a lot of listeners. Is that, everyone is problem solving in their job in some way, shape, or form. Whether you realize it or not, you’re probably doing something where you realize that this doesn’t work, or this isn’t ideal, and you’ve either created a shortcut yourself, or maybe you don’t even realize it, but everyone is problem solving on the job. It’s just a matter of maybe being in tune to that, and starting to expand your thinking with, how can I find a solution that works for a larger amount of people, or that can be applied on a larger scale. I thought that was just really beautiful to tap into.

Something else that I would love to ask you is, what stage of your life were you in when you were developing this company? So something that we hear about a lot is that I have this great idea, but I have student loans, or I can’t leave my job, I have X, Y, and Z that are going to be prioritized before I prioritize my own career. Where were you in your personal and professional life when you were developing Pharmesol? If you just don’t mind sharing a little bit of that, I think that’ll be inspirational to the listeners too.

[0:23:09] NP: I was never earning all that much. Let’s just start there. I didn’t have much to lose if that makes sense. From kind of typical, like financial perspective, right? It’s because I was – I would say, I was still fairly early in my career. It’s not like I had developed 20 years of my career, and I’m already in some advanced leadership role at an organization with great comp package, with stock options that just aren’t worth so much. It’s hard for me to walk away from that. That’s not where I was at in my career. I do think, honestly, that helped me in kind of taking a leap of faith. Another thing is, I guess, because that’s where I was at my career, I think my lifestyle was in a certain way, it was very modest again. So I didn’t have to make a lot of lifestyle adjustments if I were to be in a state where I really needed to preserve my runway to be able to focus on kind of this venture.

So you can think of that as a negative thing. But then, it I guess kind of worked out for me. I also say that because I have seen a lot of people around me who are kind of like golden caught essentially. They have really well-paying, high-paying jobs, and that makes them hard to leave. I don’t really think it’s a bad thing to pursue financial security, I think it’s a great thing. So it’s probably – I guess, if you have a question about, it doesn’t make sense for me to leave this financial security to pursue this venture. That might be a sign that maybe it’s not worth it. The fact that you’re kind of wondering about that.

I guess one thing I do want to mention is, starting a company is really difficult. It has been very difficult. Not to say not pursue it. I do think it is a decision that takes a lot of consideration, and ask yourself honestly like, “Why do I want to do this? Is this worth it?” I think there are a lot of low-risk ways to try to validate the problem, idea, the product, and then de-risk it for yourself, and then jump into it. So then you’re more comfortable, and you’re really able to focus on it, rather than worrying about financial security.

[0:26:17] CS: I think that was really well put. So there’s certainly an element of sinking or swimming in starting a new business venture and going full in to see if it works. But unfortunately, that’s not conducive to necessarily financial security or stability. That’s something that we really want to highlight on this podcast too, is that it’s amazing to step into these nontraditional roles, and there’s so much opportunity, but there’s so much variability in how that can be done. A lot of it also comes down to the risk tolerance of the person who’s going to end up making that jump. Where does your risk tolerance lie? Are you really risk averse? Are you going to need to try a bunch of things while you’re still in your financially secure position? Or are you going to be better off taking a huge leap of faith and you’ve got a high-risk tolerance, and you can figure these things out as you’re kind of flailing along?

Everyone is really different, and I think that was really beautifully put about. There’s ways that you can make this a lower-risk jump, while still staying in your current position. Because starting a new company is extremely difficult, like we talked about – there’s so many things you don’t know that you don’t even know until you’re forced to face them with aspects of the business and finances. I just think that was really well said, and thank you for that insight.

[0:27:39] NP: Yes, of course. Just one thing I want to add is, I think one thing I realized over, and over, and over again is, nobody has the answer for you. Literally, nobody knows. I think one of the things, particularly as a first-time founder, I seek out a lot of advice, and there are so many conflicting advice, yet everything is valid. I say that to say, I think some people will probably in this topic in particular like, “Oh, you should take the risk when you’re younger because like it makes sense. You just have less obligations.” Others might say, “Oh, it’s better till you have financial security. You have some kind of leeway to make investments, and then still – if it doesn’t work out, you still have kind of a lot of savings that you can leverage.

But I mean, none of these are really like answers. It’s like, I think only you can figure out what is right for you. So I think just having a lot of honest conversations with yourself is probably the only thing.

[0:28:55] CS: Well, hey, you know what, that answer is very valid, along with the million other answers that you can get from a bunch of different people. I kind of want to shift this conversation a little bit into the evolution of the profession alongside technology. I feel like you’re in a great position to maybe speak to what you think pharmacy will look like in the coming decades. So, I have – it’s a totally loaded question, and there is no right or wrong answer. I can see your face on the screen right now.

But I have a lot of very progressive thinkers and pharmacy entrepreneurs in my orbit, and that’s just a constant conversation piece. What is pharmacy going to look like when a lot of traditional dispensing roles can be outplaced and outpaced with technology? So you’re in a position where you worked a lot with computer information and artificial intelligence and you’ve got a company that’s really relying on those things. What do you think pharmacy is going to look like in the next couple of years, and just any advice for pharmacists that are maybe a little hesitant to address the technology evolution that’s upon us?

[0:30:12] NP: I personally think pharmacy is a huge opportunity area, or just healthcare industry overall. That’s because I think it’s a lever that hasn’t been pulled as much, leveraged as much. Because when I share what I’m doing with Pharmesol, a lot of people actually – their reaction is, “Wait, that like makes so much sense. Why is this not happening today? How come nobody’s asking me if I’m doing okay or how I’m doing?” It’s so obvious when you paint a picture of how it could be, but that’s not the case for a lot of people. That’s why I say, I think there is so much untapped potential and opportunity here for our society, but also for healthcare organizations. That’s partly because I’m bullish on healthcare moving towards value-based care.

I mean, you see these value-based care organizations that are being very profitable because they’re taking on the risk, but they’re also realizing those rewards, which is why I think we will just progressively increasingly move towards value-based care, and what levers do we have to really improve health outcomes. 

I mean, there could be multiple, but I think pharmacy is an obvious one, and leveraging more pharmacists to provide this care. This is also a framework for our success as well because, as mentioned, we are able to really supercharge the clinical team, to be able to more efficiently, and effectively improve patient experience, and then patient outcomes. That’s what I think about the future of pharmacy.

[0:32:21] CS: I love that. I love supercharging the clinical team. I don’t think I’ve heard that phrase before. But I love the evolution of really moving towards value-based care. I completely agree with you. I think that that just has to be the direction that we need to move in order to provide outcomes that can be financially sustainable, but also just supercharging the clinical team with using a pharmacist. It’s so hard on a national level to even measure this because every state uses pharmacists so differently, which is certainly a barrier. But really loving the idea of the profession is underutilized overall. And being able to finally leverage us to practice towards the top of our license in positions like this, and in roles like this, I think will just be a complete game changer for the profession. I love your mindset and I love that you’re bullish on the value-based care model.

Natalie, I’ll kind of wrap things up. I’ve got three questions just to kind of roll off the tongue and provide a little bit of a well-rounded oversight with you being an entrepreneur in a non-traditional pharmacy space. But what is the most memorable thing or event that has happened to you since being a pharmacy entrepreneur?

[0:33:38] NP: Wait, this question is actually really hard. Let me –

[0:33:43] CS: Yes, take your time. It’s all good.

[0:33:43] NP: Most memorable? Okay, I think a couple of things come to mind. I think the first one is when we first put up our product. So we use text messages, and then when I got the first text message from our system, that was pretty exciting. The other thing was, once we started working with patients, patients sent us this response with thank you with the heart emoji. For some reason, I didn’t expect patients to be using emojis. We work with a primary care clinic and it’s a lot of like elderly patients, right? I mean, they text us, but for some reason, I didn’t expect them to send us an emoji. So like, I remember seeing that and just being really happy about that.

[0:34:39] CS: Something so simple and so common, just seeing it put it all together.

[0:34:45] NP: It was very inspiring. I was like, “It was all worth it.”

[0:34:49] CS: No, that’s very cute. That’s so meaningful too, especially coming from the patients. That’s when you know it’s reached your end user, it’s finally making a difference, certainly emotional. What is your favorite part in general about being an entrepreneur and taking ownership of your career path?

[0:35:06] NP: I think this also is in two parts. One is that, I love learning. I think that sort of has been like the North Star in my career, in every role I had. That’s like what I wanted to do, just understand more, learn more. I think entrepreneurship is a great place to do that because so many things I don’t know.

[0:35:30] CS: Endless.

[0:35:31] NP: And so many problems to solve. I think the other is the autonomy. Like, “Okay, here’s this problem, and I’m going to solve this problem today” or “I’m going to do something about it.” That feels really, really empowering.

[0:35:50] CS: I love both of those. You’re right, being your own boss, it’s great to have the autonomy to do what you want. But there are always problems to solve, and you will always be learning. A great combination of two things for you to be successful as an entrepreneur. Last question I have for you is, one piece of advice for anyone that’s contemplating a non-traditional career path.

[0:36:14] NP: One advice. I would say, I would tell them to do something about it. I think that’s maybe one thing that I might be better at than sort of like average people, like execution. It’s not that I’m like doing something well, but I’m doing something. I think that has sort of eventually kind of led me to this path. This can include things like reaching out to people that you want to connect with, and learn, and hear about their story. Or listening to this podcast, I think would be a great example of doing something about it. But I think those are the actions you take, I think eventually become your experiences, and then insights to making decisions in the end. 

[0:37:08] CS: That’s great, great response. Natalie, if the viewers want to reach you and want to take some more action, where is the best place that they can learn more about Pharmesol or connect with you?

[0:37:21] NP: Yes, so I’m pretty active on LinkedIn, so they can find me on LinkedIn. Or my email is [email protected], so they can reach me through my email as well.

[0:37:35] CS: Perfect. We’ll link both of those things in the show notes. We’ll also link the direct website to Natalie’s company, Pharmesol if you want to really see what the product looks like, and learn more about the company. But Natalie, thank you for being here today. We love having pharmacists that are really pushing the profession forward. I think that’s exactly what you’re doing, and it’s beautiful to see, really the pharmacy profession evolve in a meaningful way alongside technology. It was so insightful to hear your responses, and your viewpoint, being a working, living example of someone who’s going to be really successful in that space. Thanks for being here today.

[0:38:16] NP: Thank you so much. I’m super excited to be working with pharmacists, and empower them, and inspired by them as well. Thank you so much for having me. 

[0:38:27] CS: Perfect, thanks.

[END OF INTERVIEW]

[SPONSOR MESSAGE]

[0:38:30] JW: Hey, this is Justin again from the YFP team. Thanks for tuning in to today’s podcast. If you’re a pharmacy professional, you know how crucial it is to have access to reliable drug information. That’s why we’re excited to tell you about Pyrls, today’s podcast sponsor. Gone are the days spending hundreds of dollars for access to drug information. Pyrls offers top drug summaries, clinical teaching points, a drug interaction checker, calculators, and guideline reviews all in a user-friendly resource. Whether you prefer accessing information to your web browser, a Chrome extension, or mobile app, Pyrls has got you covered. Plus, for a limited time, you can visit pyrls.com to get access to more than 25 free pharmacotherapy charts to get you started. Upgrade your drug information resource today with Pyrls. Visit pyrls.com. That’s P-Y-R-L-S .com to learn more. Thanks again for listening.

[OUTRO]

[0:39:23] TU: As we conclude this week’s podcast, an important reminder that the content on this show is provided to you for informational purposes only and is not intended to provide, and should not be relied on for investment or any other advice. Information in the podcast and corresponding materials should not be construed as a solicitation or offer to buy or sell any investment or related financial products. We urge listeners to consult with a financial advisor with respect to any investment. 

Furthermore, the information contained in our archive, newsletters, blog post, and podcast is not updated and may not be accurate at the time you listen to it on the podcast. Opinions and analyses expressed herein are solely those of your financial pharmacist unless otherwise noted, and constitute judgments as of the dates publish. Such information may contain forward-looking statements, which are not intended to be guarantees of future events. Actual results could differ materially from those anticipated in the forward-looking statements.

For more information, please visit yourfinancialpharmacist.com/disclaimer. Thank you again for your support of the Your Financial Pharmacist podcast. Have a great rest of your week.

[END]

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YFP 326: #PharmGradWishlist: Supporting Racially & Ethnically Minoritized Pharmacist Trainees


Drs. Lindsey Childs-Kean and Britny Brown share their work with #PharmGradWishlist to support emerging racially and ethnically minoritized pharmacy trainees.

Episode Summary

It is no secret that there are minorities underrepresented in pharmacy despite the evidence suggesting that racial concordance matters. Joining us today are two individuals, Lindsey Childs-Kean and Britny Brown, who are committed to improving representation by supporting emerging racially and ethnically minoritized pharmacy trainees. You’ll hear about the incredible PharmGradWishlist organization, what its mission is, why it’s important, and how to get involved.

About Today’s Guest

  • Lindsey Childs-Kean is a Clinical Associate Professor in the Department of Pharmacotherapy and Translational Research with the University of Florida College of Pharmacy. She earned her PharmD degree from University of Florida and completed a PGY1 residency at Tampa General Hospital and a PGY2 Infectious Diseases residency at the South Texas Veterans Healthcare System.  Her teaching, research, and practice interests include infectious disease pharmacotherapy and professional development of students and new practitioners. She is active in many professional organizations, including being a member of the PharmGradWishList Leadership Team and an Associate Editor for the American Journal of Pharmaceutical Education.

  • Britny Brown, PharmD, BCOP is a Clinical Associate Professor at the University of Rhode Island. Her clinical practice site is Smilow Cancer Center in Westerly, RI, where she focuses on the management of patients receiving oral anticancer therapy. Britny also has a passion for health equity. She is co-chair of the Diversity and Globalization Committee within URI’s College of Pharmacy, is a leadership team member for PharmGradWishlist, and is a member of the HOPA DEI Advisory Group.

Key Points From the Episode

  • Welcoming Lindsey Childs-Kean and Britny Brown and why they were drawn to this field.
  • All about PharmGradWishlist and what the goal is. 
  • How PharmGradWishlist got started and what inspired our guests to get involved. 
  • Why underrepresentation matters in this profession and healthcare at large. 
  • The differences between internal and external support for minorities in the pharmacy field. 
  • Financial issues minorities, in particular, face as they transition to pharmaceutical residency. 
  • How listeners can learn more about PharmGradWishlist and get involved in their mission. 
  • What’s in the cards for the future of PharmGradWishlist.

Episode Highlights

[PharmGrad Wishlist’s] mission is to promote equity by sponsoring racially and ethnically minoritized pharmacists and pharmacists’ trainees as they progress through the profession.” — @HemeOncPharm [0:03:32]

“Racial concordance does correlate to improved health outcomes, increased patient satisfaction, decreased emergency room utilization, and decreased health care utilization.” @HemeOncPharm [0:13:25]

What we’re focused on doing with PharmGradWishlist is supporting those individuals who are in pharmacy school and in the pharmacy profession, as they move through the profession.” — @corevalues5 [0:16:28]

“We’ve told you about what we’ve done [in] the last two years and we really think we’re just getting started [with PharmGradWishlist]”@corevalues5 [0:24:55]

Links Mentioned in Today’s Episode

Episode Transcript

[INTRODUCTION]

[0:00:01] TU: Hey, everybody. Tim Ulbrich here. Thank you for listening to the YFP Podcast, where each week we strive to inspire and encourage you on your path towards achieving financial freedom. This week, I welcome Lindsey Childs-Kean, and Britny Brown to the show to talk about PharmGradWishlist and the vision they have to support racially and ethnically minoritized pharmacy trainees. We discuss the inspiration for PharmGradWishlist, the impact that it’s having, and how others can get involved. 

Before we jump into my conversation with Lindsey and Britny, let’s hear a brief message from YFP team member Justin Woods. 

[YFP MESSAGE]

[0:00:33] JW: Hey, Your Financial Pharmacists community. This is Justin Woods here, Director of Business Development at YFP. You may be one of the 13,000 pharmacists that have already signed up for YFP Money Matters, which is our weekly newsletter, but if you’re not, what are you waiting for? I want to invite you to subscribe. We send financial tips, recommendations, the latest podcast episode, and money resources, all specifically for pharmacists. It all comes straight to your inbox every Friday morning, so visit yourfinancialpharmacist.com/newsletter, or click the link in the show notes to subscribe today. Again, that’s yourfinancialpharmacist.com/newsletter. See you there. 

[INTERVIEW]

[0:01:19] TU: Lindsey and Britny, welcome to the show. 

[0:01:21] LCK: Thanks for having us, Tim. 

[0:01:22] BB: Thank you so much. We’re very excited to be here.

[0:01:24] TU: Lindsey, let’s have you kick us off by introducing yourself to our listeners, including what drew you into the profession and the work that you’re doing now. 

[0:01:35] LCK: I’m Lindsey Childs-Kean. I’m a clinical associate professor at the University of Florida College of Pharmacy. My clinical area of specialty is infectious diseases, but I do most of my time as a faculty member teaching and mentoring pharmacy students. I could talk a long time about how I got into pharmacy school because I took a very weird trajectory to pharmacy school. Basically, I ended up making the decision that in looking at the healthcare system, there was so much that pharmacists could do that I wanted to be a part of that. So, that’s why I went to pharmacy school. Then I also have a master’s of public health degree and my specialty was global infectious diseases. That’s how I got into the infectious disease area and did two years of residency, including an infectious disease residency after pharmacy school. 

[0:02:25] TU: Great. Britny, how about for you? 

[0:02:27] BB: Yeah. Thanks for having us. I’m a clinical associate professor, as well, at the University of Rhode Island. My area of focus is oncology. I would say my trajectory into where I am now started with just being interested in pharmacy, learning more about medications, and how we can improve health outcomes. Getting into cancer care, I was initially really intimidated, because it’s a different language, but seeing the impact that we can have is what drove me towards specifically working with that patient population. 

[0:02:59] TU: Great. Well, we are excited to have both of you. While you had great pharmacy careers, that’s not what we’re here to talk about today. We’re going to be focusing rather on the work that you and others are doing in leading through the PharmGradWishlist. Britny, let’s start with you. Tell us more about PharmGradWishlist. What’s the mission? How did it get started? What’s the goal? What are you trying to achieve? 

[0:03:21] BB: Absolutely. PharmGradWishlist is a mutual aid organization of 10 practicing pharmacists across the country that make up our leadership team. Our mission is to promote equity by sponsoring racially and ethnically minoritized pharmacists and pharmacists’ trainees as they progress through the profession. We did model this after a similar movement in the medical community called MedGradWishlist. It’s evolved to more than just wish lists. That part stems from individuals, trainees usually, making Amazon wish lists and what they need to enter into their pharmacy profession. 

It might be a variety of different things, office supplies to help them get started, study materials, and sponsors nationally can work through and identify individuals they’d like to sponsor as they enter their career. In addition, we’ve also created a scholarship program for the last two years now going into our third year for individuals that are seeking postgraduate training. We have some stats with that. 

Our first year, we sponsored $2,500 scholarships. In our second year, which was 2022 through this spring, we sponsored 39 scholarships. That encompassed actually just 85 unique donors. The large vast majority of donors actually contributed a significant amount to our sponsees. We really hope to continue that momentum and bring our movement to other people’s attention. I’ll let Lindsey talk a little bit more about what else we’ve done with our movement as well. 

[0:05:03] LCK: Yeah. Also, to note, in addition to that number of scholarships that we’ve done over two years, we also have had well over a hundred wish lists each year that have been available for sponsors to choose to support our sponsees. Outside of the wish lists and scholarships, those are obviously our two really big initiatives that we do each year. We’ve also been able to work with a number of racially and ethnically minoritized trainees in publishing, commentaries, and other types of articles. 

We have at least five published papers to date, depending upon when this goes live. If something else might be published by then, and we’ve got some others in the works. So, we encourage the listeners to go read those publications. We also – because we are recruiting sponsors and sponsees, we put a big focus on communications. We have a website. We also have a blog, where we will write about different issues that are related to racial and ethnic concerns. 

We’re also active on multiple social media platforms. So basically, if there’s a social media platform, we’re probably there. One other thing that we have looked or to expand out is partnering with other pharmacy organizations, both national and state level and regional organizations. These take different flavors of what we do to help support their trainees in that particular area or within their mission and scope. 

[0:06:37] TU: If I heard the two of you correctly, really three major areas, scholarships, wish lists, and now on the publication dissemination of information with an expansion going out to organizations and opportunities for them to get involved as well. Really incredible work. First of all, congratulations. I mean, to see the grassroots efforts of that. I mean, 20 to 39 scholarships. I mean, that’s a big impact. There are over 300,000 pharmacists in the country, right? Britny, I think you mentioned somewhere in the 75, 80-ish donors that went –

[0:07:11] BB: Yeah. 85 donors this year Yeah.

[0:07:13] TU: 85. What an awesome opportunity. We’ll talk about that at the end of the show, as well. For folks that want to get involved. Let’s do it, right? Great work that’s being done, but also great opportunities that are still to be had as you look to grow the impact that your work is doing. Lindsey, my question here is why get involved with PharmGradWishlist, right? There’s lots of different opportunities to give back, to be involved. Certainly, this is an investment of your time, as well as the others that are on the leadership team. What really is the motivation for you to get involved? 

[0:07:46] LCK: Some of our backstory is that pharm, the leadership team really formed over the social media platform that used to be called Twitter. One of our leadership team members said, “Hey, there’s this MedGradWishlist thing going on. Why don’t we do it in pharmacy?” It was an informal call for others to get involved. The more I looked into it, I really gravitated towards the very tangible method of support. It’s one thing to donate money or time to a big national organization, but you don’t always know where that money and time and effort are going to. Whereas with this, I know very specifically. 

If I buy a set of scrubs for a trainee who’s going to be starting residency in a couple of months, that’s very tangible or if I donate money towards a scholarship, I see that money going directly to that recipient. It’s a very tangible way to support our efforts to diversify and make our profession more equitable. That’s what drew me to PharmGradWishlist. 

[0:09:01] TU: Yeah. I really like what you said there. I recently had on the podcast, Tom Dauber, who has a career in advancement and giving, working with institutions, most notably colleges of pharmacy. One of the questions I asked him is what are donors often looking for, right? Is there making a selection or a choice of a gift? He talked exactly about what you said impact, right? Being able to see or feel directly, not only that there’s an alignment there of something that they care about, but that they also can be able to see that change or see the impact that that gift is happening. Britny, what about for you? What was the motivation, the inspiration for your involvement? 

[0:09:39] BB: Similar to Lindsey, I was just felt very lucky that our colleague Betsy had reached out to us, identifying that we’re all like-minded individuals that wanted to see change in terms of representation in our profession. I think probably similar to many of our listeners, not many of us knew where to start, right? There was an infrastructure that existed to help make that change. I think that’s what PharmGradWishlist provides, right? That tangible impact that Lindsey was talking about, but also giving you the infrastructure. 

Hopefully, it makes our supporters easily able to access that, right? To see change tangibly in a short period of time, but also to not have to do much work to get there. You just click a link, provide your money or decide what you want to give to someone on their wish list. It’s really as easy as five minutes of your time. 

[0:10:36] TU: You guys have done a great job with the website. I think it very succinctly talks about what you’re doing, why you’re doing it. For those that are eager to go look at that, we’ll mention at the end as well, link to it in the show notes. It’s pharmgradwishlist.org. Again, it’s pharmgradwishlist.org. I want to talk a little bit, and Britny, I’m going to start with you and Lindsey, feel free to jump in as well. 

There was a commentary that the two of you, as well as a group of others, were involved with, published in JAPhA in 2022, we’ll link to it in the show notes. The title was Brighter Horizons: The Necessity of Concentrated Sponsorship Targeted Toward Minoritized Student Pharmacists. Talking a lot about the why and the how of what you’ve been building at at PharmGradWishlist. Britny, perhaps an obvious question, but one that I feel needs to be asked is, why does this mission matter? Why does under-representation matter in our profession and health care at large? 

Let me read one passage from the commentary and then get your take on it. That passage is, “Since the American Association of Colleges of Pharmacy began reporting data on races and ethnicities of student pharmacists in 1985, students who identify as Black, Hispanic, or Latinx, American Indian, or Alaska Native have enrolled and graduated at disproportionately lower rates compared with their demographic makeup and the US population.” Why does that matter? 

[0:12:00] BB: That’s a great question. I’m so glad that you’re asking it. I think we hear a lot of representation matters, right, regardless of whether we’re talking about pharmacy, medicine, politics, seeing oneself in their profession helps others to envision that they could potentially one day be there. We’re pharmacists. We like data. There is data that exists in the healthcare realm that having representation improves health outcomes. 

Much of this data stems from medicine, doctors that have decreased morbidity and mortality when they have racially concordant providers. That’s there. We know that it decreases mortality with physicians. Unfortunately, that data hasn’t been found yet in pharmacy specifically, however, there has been data that looks at how we improve adherence just by being racially concordant. One could potentially extrapolate that to say, if you’re more adherent to your diabetes medications, you’re more likely to gain control of your diabetes, likewise with hypertension and cancer. 

I think that it’s just an opportunity for us to do more research in this area. It’s something that we’re certainly advocating for our pharmacy colleagues to pursue, but we do know that overall, within medicine, that racial concordance does correlate to improved health outcomes, increased patient satisfaction, decreased emergency room utilization, and decreased health care utilization for sick visits and things like that. There’s certainly a precedent that we could set with our research if we have the resources to pursue it. 

[0:13:49] TU: Which goes back, I think, so well to the mission, right? You’ve got some tangible opportunities for people to get involved in needs that are there right now. Then when you talk about the research, the publication, the efforts as more individuals, as more organizations get involved in this, obviously those resources can be really important to allow that research work to be happening and hopefully to add to the literature, you know, what’s currently is missing in the pharmacy profession. 

Let me continue to put you on the hot seat while I have you there, Britny. In the commentary, it also mentions, “Dismantling structural racism within pharmacy programs requires evaluation of internal and external factors and creation of novel methods to support these students in a holistic manner.” What are a couple key points as it relates to internal versus external and the difference between those? 

[0:14:37] BB: Yeah. That’s a great question too. I like to think of internal as within our own pharmacy programs. Whatever structure we have in place, which might include policies, procedures, our institutional status quo, what have we been doing for the last 100 years that might be inherently racist and how do we examine that through an equity lens to see how we might better support our students, right? What microaggressions are occurring in the classroom between professors and students, students to students that we can improve upon to make students feel like they are empowered to succeed in school and then their profession. How do we retain our diverse learners? 

Then externally, I would think of that more as how do we bring diverse people into our profession. Externally, as you said, we don’t have good racial representation. How do we, in a world that is inherently racist, engage people who hadn’t traditionally seen themselves in our profession or maybe don’t have the same opportunities to accessing postgraduate training as an example? I think those are – that’s the lens that I view it in. I think there’s a lot of different nuances to it that we probably can’t – don’t have the time to get into today, but maybe just some surface-level viewpoints. 

[0:16:03] LCK: Yeah. I think one of the things to take away from this is one initiative is not going to solve all these problems. PharmGradWishlist has a very specific mission that we’ve already laid out. We’re not going to do anything about those upstream factors that are preventing diverse groups of people that are getting into pharmacy school, but what we’re focused on doing with PharmGradWishlist is supporting those individuals who are in pharmacy school and in the pharmacy profession, as they move through the profession. We at this point aren’t able to tackle every problem out there, no initiative is. We had to pick something to focus on. This is, as we’ve said, a very tangible way to support the individuals so that hopefully, they are able to bridge the issues and structural racism that they’ve had to face to get to the point that they’re even at. 

[0:17:05] TU: Yeah. Speaking of very specific ways to get involved, Lindsey. One of the things that that commentary I think does a nice job of calling out is when we think about residency as just one example, of other efforts that you have ongoing. One thing is that even in talking about this every week some of the connections that may not be so obvious is, hey, traditional financial aid, right, which can lead to student indebtedness and other challenges, but there’s access to resource there does not extend to those additional costs, right? 

When we think about what we often see as somebody who goes through their P4 year, they transition into residency or in a fellowship, it is a very difficult financial time, right? Especially if they’re applying out of state, application costs, licensure, moving, new things that come with any type of transition like that. Just talk more about why that transition is so important and why PharmGradWishlist is wanting to really have an impact. For that group where, again, financially, it may not play a role in being able to support those students. 

[0:18:10] LCK: You’re absolutely right, Tim. Students get a set amount, a set maximum amount of money every year. That doesn’t matter if you are all of a sudden in your last year of pharmacy school and want to pursue postgraduate training and in all likelihood, that’s going to entail some professional clothing to do an interview, likely travel to do interviews, although more and more programs are doing virtual interviews, which that does sometimes help level the playing field a little bit. Those things just to get to the interview point.

In addition to the fees for applications through forecasts and all of that. Then once you get to, as you mentioned, the transition financial aid ends after that last semester. There’s licensing fees. There are moving fees. Lots of different things that happen. A lot of our students, once they start their first job, they are also in the process of setting up some kind of living arrangement, an apartment or house or something like that. These wish lists are meant for them to put whatever it is that they need for that. 

Again, I bought everything from reference textbooks, to kitchen utensils, to scrubs, to really nice-looking pillows so that they can sleep well off of these wish lists. Not having some financial backing of parents or other individuals is very common in our students and trainees who come from racially and ethnically minoritized groups. They don’t have that extra cushion, like I did in pharmacy school where I was like, “Hey, dad, I need an extra $500.” For whatever it was when I was transitioning to residency. A lot of them don’t have that. That’s where the wish lists and the scholarships come into play, where that is again, tangible money or items that they need in those times where money is probably even more tight than it is to begin with. 

[0:20:28] TU: Yeah. I think the further, well said, the further we get from graduation or some of us were in these shoes. I think the harder it is for us to remember the feeling that that was, right? I often talk with students and those transitioning that just have this overwhelming feeling as if they’re drowning financially, right? They’ve got these things that they want to pursue, but there’s just so many transition things that are happening. Obviously, student loans are coming back online. They’re making moves, as you mentioned. 

We actually have an article on our site. I was just pulling up as we were talking here that Brandon Dyson from TLDR wrote a few years ago on the cost of the pharmacy residency quest, and he broke it down into three phases, the application, the mid-year trip, and then the interview. That doesn’t even account for any of the costs with the transition, right? Once you actually start that residency. When you start to add these things up, like in the application, you’ve got registration for the match, registration for payment for the forecast applications, potentially transcripts that you have to acquire. 

Then you have the mid-year trip if you’re pursuing that and all of the travel and costs that come with that. Then obviously the travel and costs that come with the interview as well. You start to stack some of this up and it adds up. That typically is a year where financially, because experiential rotations are often a significant financial burden for students. This is something even on top of that as well that causes some stress. Such a necessary, I think effort to help those students in the transition. 

Britny with that in mind is people are listening to this and say, “Hey, I want to help. I want to support. I want to get involved.” Whether that’s with the scholarships, whether that’s with the GradWishlist, whether that’s just staying up to date with what you guys are doing, some of the research that you’re doing. What’s the best place that people can go to learn more and as well to get involved with support? 

[0:22:21] BB: Absolutely. Our website that you mentioned pharmgradwishlist.org is a great place to start. You can actually sign up for our email list at the bottom of the website. If you scroll all the way down, enter in your email, any page on that website to stay up to date on what’s going on. We will send out communication with scholarships and wish list go live. In addition, we have social media platforms on Twitter or X as it’s now called, as well as Instagram on both our handle is pharmgradwish. Then on LinkedIn, we are PharmGradWishlist. You can find us on Facebook as well. 

[0:23:02] TU: Awesome. What about individuals? I think many people listening are probably interested in getting involved as an individual, but if someone is a leader within an organization, whether it’s an association, as was mentioned previously, whether it’s a for-profit company and they want to get involved with making a donation. Are there opportunities for organizations, companies to get involved as well? 

[0:23:25] BB: Absolutely. I think probably the best way if you’re interested in having a higher level of support would be to email us at [email protected] or you could contact us through our website. Either of those should be good ways to get started. That being said, if you are an institution, we have had individuals rally their departments and their colleagues to support scholarships. We’ve had a few instances where they supported multiple scholarships, which was amazing. 

Then of course, just helping to get the word out is extremely impactful. As we mentioned earlier with our scholarships, we had 85 sponsors. Imagine if we could reach even 1,000, which is still just a fraction of practicing pharmacists in the United States. So, help us get the word out, share through your institutional newsletters and email lists serves when the time comes that our scholarships are live and wish lists are live. 

[0:24:27] TU: Awesome. We’ll link to that email address as well. You mentioned [email protected] for those that want to reach out with questions or I know we have business owners listening. I know we have organization leaders listening that can either, potentially, get involved from a donation in that standpoint, individually or getting their constituents and members involved as well. Lindsey, what does the future hold? What are some of the future directions for ParmGradWishlist? 

[0:24:53] LCK: Yeah. We’re excited. We’ve told you about what we’ve done the last two years and we really think we’re just getting started. We’re looking into additional partnerships with national pharmacy organizations to expand our reach to both trainees that could be sponsees, as well as sponsors to help support our sponsees. We are looking into pursuing nonprofit status. Up until now, it’s been just us doing the work, but we’re looking to potentially be more formal as a nonprofit organization. Which we do hope that if we pursue that and then eventually get a 501(c)(3) designation. We hope that will also drive interest in supporting our initiative. 

Then as we expand, we have also talked about maybe setting up a committee structure, where we might be able to bring additional people on board to do some of the work of the initiative. Again, the website and being signed up for the email listserv are the best places to keep up to date on how all of those things, progress. Highly recommend going to the website pharmgradwishlist.org and signing up for the email alerts. I promise we don’t send very many. It’s only when we have big things that are happening. 

[0:26:15] TU: Awesome. Well, that will be the challenge to our community. Make sure you’re informed with the work that is being done at PharmGradWishlist. You’ve got the website pharmgradwishlist.org, you can sign up for the newsletter if you’re ready to make a donation and get involved. You can do that as well. Let me wrap up our time by reading a couple of the words of support that you have from sponsees on your website that I think encapsulates so well the impact that you all are having and the work that is being done. 

The first one is from a 2021 grad who said, “I wanted to reach out and thank you all for the amazing work you’re doing with the PharmGradWishlist. You’ve taken the time out of your busy schedules to do this wonderful act of kindness for your future colleagues and it hasn’t gone unnoticed. As a graduating student, I am awe-inspired by the amount of care and effort you have put into this initiative. Thank you for all your hard work. You are changing lives.” 

From another recent grad, “My goals after graduation are to care for the underserved population and bridge health disparities through direct patient care as a community pharmacist in my home state. Going forward, I hope to become a mentor to other first-generation, Asian-Americans with goals of becoming a pharmacist as I know how difficult it can be when it comes to preparing and applying for a competitive program with little guidance. With graduation just around the corner, I am extremely grateful to PharmGradWishlist and the entire family for helping me transition from a student pharmacist to a pharmacist.” 

Amazing words there. I think just so well, really again encapsulate the work that you all are doing. The impact that it has and for those that are looking to get involved to make a donation, the impact that that donation is going to have. Britny and Lindsey, thank you so much for taking time to come on the show to share the journey and I look forward to following the success ahead. 

[0:27:54] LCK: Thanks so much for having us, Tim. 

[0:27:56] BB: Thank you.

[DISCLAIMER]

[0:27:58] ANNOUNCER: As we conclude this week’s podcast, an important reminder that the content on this show is provided to you for informational purposes only and is not intended to provide and should not be relied on for investment or any other advice. Information in the podcast and corresponding material should not be construed as a solicitation or offer to buy or sell any investment or related financial products. We urge listeners to consult with a financial advisor with respect to any investment.

Furthermore, the information contained in our archived newsletters, blog posts and podcasts is not updated and may not be accurate at the time you listen to it on the podcast. Opinions and analyses expressed herein are solely those of Your Financial Pharmacists, unless otherwise noted, and constitute judgments as of the dates published. Such information may contain forward-looking statements, which are not intended to be guarantees of future events. Actual results could differ materially from those anticipated in the forward-looking statements.

For more information, please visit yourfinancialpharmacist.com/disclaimer. Thank you again for your support of the Your Financial Pharmacist Podcast. Have a great rest of your week.

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YFP 325: Retirement Roadblocks: Identifying and Managing 10 Common Risks (Part 2)


YFP Co-Founder and CEO, Tim Ulbrich, PharmD and YFP Co-Founder and Director of Planning, Tim Baker, CFP®, RLP®, RICP®, wrap up a two-part series on 10 common retirement risks you should plan for.

Episode Summary

While a lot of emphasis is placed on the accumulation phase when preparing for retirement, there is considerably less focus on simple strategies for turning assets into retirement paychecks, for example. This week, Tim Ulbrich and Tim Baker wrap up a two-part series on 10 of the most common retirement risks you should be planning for. Today, Tim and Tim cover the five remaining risks: frailty risk, financial elder abuse risk, investment risk, work risk, and family risk. 

Key Points From the Episode

  • A brief recap of part one. 
  • Frailty risk and what its major financial effects are. 
  • How a good support system and a clear living situation can be a solution to frailty risk. 
  • Financial elder abuse risk, why it often goes unnoticed, and how to mitigate it.
  • Why unity among siblings is important to avoid financial abuse of elders. 
  • Insight into investment risk and its subsections. 
  • How ensuring that your paycheck isn’t tied to the market can solve market risk. 
  • The value of flexibility and inflationary protection to protect yourself from investment risk. 
  • How liquidity risk plays a role in investment risk. 
  • Sequence of return risk and how it can damage your overall retirement sustainability. 
  • Work risk and some of the reasons that you might have to retire early. 
  • How planning for retirement readiness at different ages can assist with work risk. 
  • What re-employment means and how it affects work risk. 
  • How the loss of a spouse affects the person left behind financially and how to mitigate this. 
  • Ways that having unexpected financial responsibility can affect your retirement plan. 
  • Why having a third party you can trust to help with unexpected risks is helpful.

Episode Highlights

“Studies have shown that, the longer you retire, the more your mental health decreases over time.” — @TimBakerCFP [0:03:25]

“Involve trusted family members [to avoid elder financial abuse].” — @TimBakerCFP [0:10:16]

“You mitigate market risk when a lot of your paycheck is – not tied to the market.” — @TimBakerCFP [0:14:12]

Links Mentioned in Today’s Episode

Episode Transcript

[INTRODUCTION]

[0:00:00.8] TU: Hey everybody, Tim Ulbrick here, and thank you for listening to The YFP Podcast where, each week, we strive to inspire and encourage you on your path towards achieving financial freedom.

This week, Tim Baker and I wrap up our two-part series on Ten Common Retirement Risks to Plan For. Now, in planning for retirement, so much attention is given to the accumulation phase but what doesn’t give a lot of press is how to turn those assets into a retirement paycheck for an unknown period of time. When building a plan to deploy your assets during retirement, it’s important to consider various risks to either mitigate or avoid altogether and that’s what we’re discussing during this two-part series, where today we cover the five remaining retirement risks, including frailty risk, financial elder, abuse risk, investment risk, work risk, and family risk.

Make sure to download our free guide that accompanies this two-part series, Retirement Roadblocks: Identifying and Managing 10 Common Risks. You can download that at, yourfinancialpharmacist.com/retirementrisks. Again, that’s yourfinancialpharmacist.com/retirementrisks. 

Before we jump into my conversation with Tim Baker, let’s hear a brief message from YFP team member, Justin Woods.

[YFP MESSAGE]

[0:01:11.5] JW: This is Justin Woods from the YFP Team with a quick message before the show. If you listen to the YFP Podcast, you may learn something every now and then, either from Tim Ulbrick, Tim Baker or one of our guests. A lot of people listen to this show but they may not execute or implement the things they learn. As pharmacists, we know the impact of non-adherence on patient outcomes and their overall well-being. 

As a pharmacist myself and part of the YFP Team, I talk with pharmacists every day who are confused about how to implement financial knowledge. Pharmacists share with me that they are treading water financially, maybe took a DIY approach, reached a plateau, and are confused about what to do next, or those who work for decades can see the light at the end of the tunnel and feel uncertain about how the next chapter will unfold. 

If that sounds like you, one, it is not uncommon to feel that way, and two, does it make sense for us to have a conversation to see if YFP Planning can help you? Visit yfpplanning.com or follow the link in the show notes to find a time that works for your schedule.

[INTERVIEW]

[0:02:16.9] TU: Tim Baker, welcome back.

[0:02:18.7] TB: Good to be back Tim, how’s it going?

[0:02:20.1] TU: It is going well. Last week, we started this two-part series on 10 common retirement risks to be planning for. We talked about things like longevity risk, we talked about inflation risk, we talked about excess withdrawal risk. Listeners can tune back to that episode. We’ll link to that in the show notes if they didn’t already listen, and we’re going to continue on.

So number six on our list of 10 common retirement risks to plan for, number six is frailty risk. Tell us more about this.

[0:02:49.0] TB: Yeah, so this is more related to – it’s a risk that as a result of either mental or physical deterioration of your health, mental health, physical health that you as a retiree might not be able to have sound judgment in managing your financial affairs or care for your home, those are the two big ones. 

So just like we talked about in the last episode, like, with long-term care and a long-term care risk, this is one that people are like, “Oh yeah, this is important but it’s not going to happen to me” and you know, what studies have shown is that you know, the longer that you retire, the more your mental health decreases over time. 

So this is going to be, you know, where we really want a good support system. So a solution here is if we work longer, obviously, our mental acuity, our mental sharpness kind of stays intact longer. We’re not as isolated, there’s lots of studies about depression and loneliness, Tim, you know, creep in.

A lot of things that have not really been talked about as regarding retirement in the past and I think a lot of this points back to some of the frailty risk. So having a good network involving your family to have help, whether it’s with decision-making or chores, hiring someone to manage money or a trustee is another good solution here. 

Set up a power of attorney for you know, the financial situation. It can even be you know, things like healthcare. Probably a big thing that I often hear is having a good discussion and analysis of like the living situation, right?

[0:04:40.9] TU: Yes, yes.

[0:04:41.1] TB: So a lot of people as they age, they might not necessarily want to move out of the house where they raise their family. A house that might be three, four, or five bedrooms that has a big yard, lots of yard work, lots of housework. Maybe stairs to go up and down and because of the – you know, kind of the emotional attachment to the house, it’s just hard for the retiree to move on and you know, potentially downsize or you know, move into a townhome or a condo or a community that is different. 

That’s probably has one of the biggest effects on the frailty risk. You know, if you’re less likely, I think, to kind of be exposed to this risk if you have, again, more people around you that are dealing with the same thing. We mentioned a trust, so potentially putting assets in the living trust that are basically managed by the trustee which could be used as a retiree and then you could have a successor-trustee, which can be a family member or family members.

But the whole thing I think is to kind of you know, plan for this. You know, we want to make sure that we don’t necessarily have to go through the courts that we can kind of do this preemptive, even simplifying the finances. So things like you know, direct deposit, you know, automatic withdraw for bills, you know annuities, checks coming in the door rather than you know, having to make decisions regarding, “Okay, how much should I withdraw this year?”

These are all things that I think would help, you know, simplify and make this risk, not avoidable but mitigated, Tim.

[0:06:14.2] TU: Yeah, and as we wrap up the previous episode, part one, talking about the importance of planning for this early, right? So here, we’re talking about potentially deteriorating mental or physical health. You know, obviously, if and when that happens, guess it’s just a matter of time, right? For all of us but if and when that happens, we don’t want to be making these decisions in that moment, right?

So, how can we be having these conversations in advance? You talked about an important one that often comes up around housing, what’s the desire? You know, I’m thinking about things like legacy folders and making sure you’ve got good systems and documentations in place. I think the housing one comes up so often, you know? I’m thinking about even my own family. Like, sometimes it’s just hard to cut through the noise on this because you know, you gave one example where people may want to stay in their own home, I think that’s a common one.

The other one that I see as well is where people are adamant on like, “Hey, I don’t want to be a burden on the family. So, just put me in a facility.” It’s hard sometimes to cut through the noise of like, where does the true desire and how is that being projected and you know, maybe there’s an interest and a willingness and the financial means for children, you know, to be able to care for their elderly parents and that’s a desire, you know? 

For them to do but you know, you can’t get through some of those conversations. So just again, I think in a point of advocacy for talking through as much of this as possible, as early as possible, and for those that are listening where you know, maybe they have adult children that are going to be important caregivers, you know initiating that conversation with your adult children and those that are the children that have aging parents, you know, initiating those conversations as well.

[0:07:49.6] TB: Absolutely.

[0:07:50.8] TU: Tim, number seven, one that’s not fun to talk about, one that we have to just given, you know, the reality of what it may be, which is financial elder abuse risk.

[0:08:00.5] TB: Yeah, and this is the risk of being – basically being taken advantage of because of frailty. So these are kind of linked, Tim, and I saw a stat out there that this can cost anywhere from like, three to 36 billion dollars a year or something like that. It’s insane and probably the biggest culprits of this is people that the retiree knows and knows well. So that could be an advisor, financial advisor. 

It could be a family member, so adult children are probably the bigger abusers of this but 55% of these cases are family members, friends, neighbors, or caregivers, and the crime or the abuse can be anywhere from bad advice to fraud, barred against the person’s home. Theft, which could either be, you know, cash, taking money out of accounts, using credit cards, embezzlement. 

You know, misuse of power of attorneys, and unfortunately and I think it’s why it’s so hard to kind of like put a number to this, in terms of like what the losses are is that the abuse often goes unnoticed because you know that retiree can be embarrassed. They really don’t want to punish those that are close to them or they have fear of losing care that is being provided even though they’re being abused or even reprisals. 

And it’s one of the things that you know, as an advisor, even though we’re on that list of abusers, that we’re kind of trained to look for and ask questions in terms of like, “Okay, is there something going on? You know, what is the cognitive ability of this person? Are they making sound judgment? You know, who in the family is involved?” That type of thing.

And there’s been you know, I’ve heard of cases where it’s like, Mr. Jones is having USD 50,000 of work you know, done to his kitchen at 85 years old and that doesn’t necessarily make a lot of sense but it could be a contractor that’s kind of taking advantage and sometimes, Mr. Jones, it’s a little bit of – it’s being taken advantage of but it’s also could be like they like the company, you know?

So I think you know, a major solution for this, I would say is you know, involve trusted family members and I underline trusted and I underline the asset members. It’s a little bit of checks and balances. You know, if you have you know, two siblings that are kind of looking after, hopefully, they’re not both, you know, criminally minded but I think it’s good to have a few people that are you know, over-watching so to speak, the situation.

I think as much as the person, the retiree can protect themselves by staying organized, tracking possession, tracking their assets, you know, as much as they can open their own mail, sign their own checks, manage their investment, manage their statements, their investment accounts, their bank accounts, you know set up direct deposit as much as they can for social security checks or annuity payments.

That can again, help, not necessarily avoid but mitigate some of the exposure to this risk. You know, screen calls, solicitations, you know, get second opinions on, you know, we come across things even with clients where like, “Is this legit?” You know, like clients that are in their 30s, 40s, 50s and sometimes are like, “Uh, it’s not.” 

So you know, get a second opinion and make sure that we’re kind of hyper-aware because this is a big problem unfortunately and it’s tough to kind of diagnose and see and you know, at every angle, you know, because often the person that’s being abused is like for what I mention, is not necessarily willing to kind of come forward with this.

[0:11:54.5] TU: Tim, I have to bring it up since you mentioned siblings. I think this is an area where there’s so many dynamics, right? Every family’s different but you know I think that when you’re dealing with assets and estates and you know obviously, one, at the end of the day, is going to get assigned as a power of attorney and you know, people that are in are not in the will and whether those conversations are transparent or not. 

I feel like, any sibling dynamics, you know, you can just put a magnifying glass on them here. So you know, Cameron Huddleston, who we were referenced in a previous episode and we had her on a few episodes ago about initiating some of these financial conversations with your parents, talks about the importance of sibling conversations in unity, ideally, easier said than done, to then be able to obviously translate that with parents as well.

[0:12:40.4] TB: Yup, absolutely. 

[0:12:41.9] TU: Tim, number eight, investment risk, we talked about this briefly in the first part of this two-part series but I think it warrants going a little bit deeper. 

[0:12:50.8] TB: Yeah, so, investment risk, I’m kind of going to break this down into kind of sub-risk to this. So what I really want to kind of address here is market risk, interest rate risk related to the investments, liquidity risk, and then kind of come back to the sequence of return risk. So if I take these in turn, market risk is really the risk of financial loss resulting from movements in market prices. 

So, unfortunately, Tim, the market just doesn’t kind of increase steadily. As we go, we have lots of you know, ups and downs and twists and turns with regard to the market which often makes us kind of queasy as – and I would say, even more. I feel like for me when I first started to invest back in my 20s, you know, I would kind of feel those investments and I’ve kind of got to a point where I get zen and I try to like not pay attention to it because again, it’s not going to affect me until hopefully 30 years in the future when I do retire.

[0:13:46.6] TU: You should do some market meditations, right? Like – 

[0:13:48.6] TB: Yeah, exactly but for a retiree, who you know, like their paycheck and their livelihood is kind of tied to the market, I could see how that could be overwhelming and distracting. So a solution here is I think, I really strive for balance and flexibility. So, we kind of mentioned in the past, like a flooring strategy.

So you mitigate market risk when a lot of your paycheck is not coming or not tied to the market. So that’s where we you know, are essentially, we’re looking at essential expenses and we’re saying, “Hey, my essential expenses or my basic needs are covered with an annuity” or social security or very low risk, you know, government securities like treasury bonds. You know, treasury bonds, notes, that type of thing and we’re good.

The other part of that is allocation. So obviously, a lower percent of your portfolio in equity, you know, particularly leading up to retirement is going to be important to kind of mitigate market risk. So even in some of the – you know, the dot com crisis, the subprime mortgage crisis, you know, the COVID crisis, like the market is still doing this but if you have less equity exposure, it might not be Rocky Mountains ups and downs. 

It might be Appalachian Mountains ups and downs, where it’s a little bit smoother but I think, knowing what your allocation and what your glide path is, actually approach retirement is going to be important and then you know finally, I think for this particular risk is kind of going back to flexibility. 

So if you’re in a year where the market is down and maybe inflation is up, you know, inflation is up, like maybe we say, “Okay, we’re not going to take that USD 15,000 out to go travel.” you know, do this huge cruise or make this, “We’re going to forego that and see when the market kind of recovers and then we’ll kind of assess it from there.” So flexibility of like, what you’re withdrawing and when I think is going to be important with regard to market risk. 

The other ones, Tim, interest rate risk. So this is related to investment risk. So this is the risk of the change in value of an asset as a result of volatility in interest rates. So what does this mean? This essentially means that when interest rates go up as they have been over the last couple of years, the price of bonds go down. So there’s an inverse relationship. So, the price of individual bonds and bond mutual funds decreases. 

So when interest rates go down, the price of bonds go up. So this is not necessarily a concern when bonds are held to maturity or what I was mentioning in the last episode, a bond ladder. So if I buy a year, a bond, or six-month bond that basically, you know, comes up at the end of the next or at the end of this year or a year, 18 months, or whatever that looks like, if it holds maturity, the fluctuation in interest rates do not affect the bond price.

So you’re kind of inoculated from that. It’s when you kind of are coming in and out of bonds, that’s where it becomes problematic. The other risk associated with this is and I’ve seen this, so one of the things that I – because I’m a nerd, but one of the things I do with my emergency fund is I buy 12 months CDs every quarter. So I have a quarter one CD. So let’s pretend I have USD 20,000 in my emergency fund. 

10,000 might be in the high-yield savings account, 10,000 might be split up between four CDs and you can kind of think of these as like bonds. So Q1, I have 2,500, January one. Q2, April one, so on and so forth. So as prices, as interest rates have gone up, if I look back 12 months ago, man, I look at that interest rate, I’m like, “Man, that’s really low”. So when I renew, Tim, the – what I’m getting in terms of interest is a lot higher. 

The opposite came true, and this is what’s called reinvestment risk. I could have this bond that I just bought at five or you know, the CD or bond that I just bought at 5% but in a year or two years, it could be at 3% and then that’s the reinvestment risk. So that’s another risk that we have to, you know, kind of be aware of. So I think the biggest they hear is, again, things that are inflation-protected. 

So any type of income stream or investment that has inflationary protection like tips or strips, any type of COLA protection that’s going to really – what’s going to be to help reduce that risk and then finally with – or not finally, the third one is liquidity risk. So this is just basically the inability to have assets available to financially support unanticipated cashflow needs. I don’t think that this is a risk that’s really inherent just to retirement, we all have this at all times. 

It might be a little bit harder to overcome because we don’t have – we don’t necessarily have cash flow from like a set job but planning for this, you know kind of plan as best you can for what could happen. So what are the situations and then what levers can we pull? What are the assets that can be sold? You know, what are things that can’t be sold, which you know, assets that can be sold. 

It could be things like stocks and bonds and things like that. Maybe not so easily, it could be a business interest or real estate. You know, what are some other things that we can talk about to pull? Whether that’s life insurance, a HELOC, a reverse mortgage, and then one of the best reasons to employ a systemic withdrawal strategy is because of the flexibility. 

Because you have this pot of money that you can reach into and say, “Okay, I didn’t think needed USD 30,000 for X but now, because that money is there and I can put it into liquid form and pour it” then you know, that’s one of the things, versus, if you were to say, “Hey, I’m going to put all my money to an annuity” that’s not flexible and that’s not liquid.

So it allows you to change your strategy in the face of you know, new information, new situations, and finally, the last one here and again, Tim, we could probably do a whole episode on sequence of return risk is this is the risk that the timing of your withdrawals from a retirement account will damage your overall return and really like sustainability.

So when you withdraw from a bare market or when the market is down, it’s more costly than if you draw – you make that same exact withdrawal in a bull market. So this is – so what we’re saying is that a large negative return during retirement, so during that risk zone, that eye of the storm of you know, 10 years before retirement, 10 years after retirement, has a much bigger impact on wealth accumulation and success in retirement than a negative return outside of that.

You know, so that’s why I’m saying that at 40, you know, I get zen because I’m like, “It doesn’t really affect me if the market goes down 40% because I know I have 30 years for it to recover” and it’s going to go down 40% a couple of times probably over the next 30 years but if I’m retiring in five years, I’m worried, Tim. 

And again, like that’s where we have to be as safe as we can, you know, throughout our wealth accumulation journey is right in that zone, you know, five to 10 years before and five to 10 years after and this is when your retirement accounts are most vulnerable to investment returns and if you think about it, it kind of makes sense because this is typically, Tim, where you have the highest balance. 

[0:21:29.9] TU: That’s right.

[0:21:31.2] TB: So wealth rises rapidly as you approach your retirement date due to the fact that you’re putting in probably the most in contributions you ever have because you know, a lot of people are like, “Oh, I didn’t do enough of this, I need to make up, I got to catch up” because of investment returns and compounding.

So that’s when you’re – you know, and the research says that in a defined contribution plan, say, like a 401(k), this is interesting, you accumulate half the value of the account in the final 10 years of savings. So we say save early and often but what moves the needle most is in the last 10 years. In the early years of savings, additional contributions can replenish account losses but later, the contributions are a much, much smaller needle mover than it is like investment losses or gains.

[0:22:21.2] TU: Yeah, and Tim, just to put – you know, I was thinking about this because I think it’s harder, especially if folks are earlier in their career to understand kind of the numbers of this. If you’re nearing retirement, you have a three-million-dollar portfolio, as you mentioned, one part that’s going to keep driving that up is typically your, maybe you feel like you had to play catch up or you’ve got more discretionary income at that phase.

You’re hyper-saving, trying to max that account but even if we just look at that three-million-dollar portfolio and assume something like a 5% return in that year, you know, USD 150,000 of growth that’s going to happen in that portfolio in that year, right? And you know, people that are early saving, the timeline to get to 150 can feel like forever, and here, we’re talking about 150 of growth in a portfolio just in that single year. So I think that makes sense.

[0:23:05.4] TB: Yeah, and if you compare that to what you can legally contribute, that’s the big thing.

[0:23:11.8] TU: Oh my gosh.

[0:23:12.7] TB: Whereas like, you know now, you’re like, “Oh, 20,500, that’s like, that might be a third of my savings.” So it’s huge. So really, what the research shows that the magnitude of the impact of a large negative investment return or shock grew as the shock occurred closer to retirement. 

[0:23:34.8] TU: Yeah, exactly. 

[0:23:35.7] TB: So it’s like if the epicenter is – if the epicenter of that shock is close to age 65 when you retire, the consequences are greater than if it were at 58, which makes sense. So for sequence risk, the order of returns becomes a far more important concern in that span of time over the breadth of the entire portfolio, particularly in accumulation, it’s the average return that matters, right? 

So one of the things that I often say is like, “Hey, you don’t need a lot of bonds in your 20s, 30s, 40s” and I would even say even your 50s unless you’re retiring in your 50s, you don’t need a ton of bonds. So you want to almost have like a cliff, where you’re very much like pedal to the metal, you know you’re primarily in equities and then when you get to that 10-year, that’s where you start shifting, downshifting considerably. 

So like a hard break versus what a lot of people do is they kind of glide into it. So in their 40s, they put a little bit more bonds, in their 50s they put a little bit more bonds and so on and I just think that and I understand why, you know, you’re kind of easing into it but I just think you leave a lot of meat on the bone with regard to investment returns but the same is true is like you kind of have to like you know, you kind of have to get into that period of 10 to 15 or 10 years pre-imposed retirement date and then start adding equities back in, which a lot of people don’t do. 

So the solution for this is asset allocation and whether you follow on collide path or not in terms of you know, percentage of equities to bonds. Knowing what that is, we often see in the accumulation phase I think not the proper asset allocation, so too heavily in bonds and then closer to retirement, actually too heavily in equities. So if you have one of those shocks where the market is down, that’s where we have to have real conversations of like, “Hey, maybe we need to push out retirement to the market.” 

[0:25:34.3] TU: Retirement date, yeah. 

[0:25:35.6] TB: The market corrects. Again, flexibility; allow for changes and what is what’s wrong. So if it’s a down market, you know either decrease the amount that we’re withdrawing or actually that the entire – shift the entire equation where you know, we’re not retiring this year or next year, we’re retiring when the market recovers and then another solution is to kind of get out of the game or at least partially convert a portion of the portfolio to an income annuity, which essentially you know, means less overall volatility because you have that income for in place. 

[0:26:10.7] TU: Yeah, Tim, great overview. The investment risk to your point, we probably can and should cover this in more detail in future episodes and I think flexibility keeps coming back as a theme but I want to acknowledge how hard that can be, right? When you talk about something like, “Hey, maybe shifting your retirement date” makes a whole lot of sense objectively, right? 

If I had planned a retirement age, I’m listening of you know, 2026 and we see the market tank in 2025 like I’ve been mentally preparing for retirement in 2026, that’s a hard thing to consider but I think that open-mindedness and the options to be able to pursue some of those things that gives you more of that flexibility to maximize your portfolio is going to be really important. The other thing I just want to mention that we see a lot because especially folks that are maybe introductory in terms of investing or learning or aren’t working with a planner. 

I’m thinking about a lot of folks that are investing heavily in target date funds, where we maybe see some of that conservative investing happening too early, in my opinion, in the portfolio, yeah. 

[0:27:12.5] TB: Yeah and just to go back to what you’re – yeah, I completely agree it is and again, not every target date fund is created equal. We actually crack those target date funds open and you can see the allocation, you know something then might be 2035. You know, if you stack up a 2035 or 2055, you know target date fund, what is in target date fund A is going to be, you know 2035 is going to be a lot different than what’s in a target date fund B that’s in 2035. 

But to go back to your other point, you know like and we’re going to get into this in the next couple of risks here, sometimes like you’ve mentally said, “All right, I’m going to work for another two years” sometimes that decision is made for you and that could be hard. So then what do you do? 

So I think a lot of these risk is like if you can kind of maintain as much control over your destiny and I think part of this is having options, particularly with things related to work, it allows you to kind of pivot and adjust and kind of parry some of these things that are thrown at you because I keep saying, “I want to retire at age 70” you know? I mentioned earlier in the first episode of this is like that might be out of my control and you know, that’s something else we have to account for. 

[0:28:36.5] TU: Yeah, if Mike Tyson were listening, he’d say, “Everyone has a plan until they get punched in the mouth” so yeah. 

[0:28:41.0] TB: Yeah, exactly. 

[0:28:42.4] TU: So let’s talk about that, work risk is number nine on our list. What is that? 

[0:28:46.5] TB: So again, I’m going to break this down into some sub-risk. So the first one would be forced retirement risk. So this is the risk that work well and prematurely because of poor health, disability, job loss or to care for a family member because of some of these issues and this is an eye-opening stat, Tim, is 40% of retirees retire earlier than they plan and it’s really because of one of those issues, health, job loss, caring for a family member. 

This happened to my dad. My dad tells the story, you know, when we try to talk about this, you know his company was bought by another company. He was kind of duplicitous, you know, kind of at the tail end of his career and he was laid off. So it was – so if he was planning to retire by X and his portfolio and all, we had to kind of reconfigure, jostle things around, and make sure that we’re planning accordingly. 

So I think having like a pulse on kind of your retirement readiness at different ages, “So okay, what happens to my plan if I have to retire 10 years before I want to?” So for me, it will be 60, right? 65 like what happens. 

[0:29:54.8] TU: Yes, zero, one, two, three. 

[0:29:56.3] TB: Yeah and you know, what happens to my lifestyle, you know, what do I have to – like are there things that I, other levers that I can pull? So one of those I think is career. So I think staying current, you know learning new skills. You know I think, Tim, like we’re naturally like this as like lifetime learners and always trying to you know, self-improve. That’s not everyone’s cup of tea but I think maintaining your network. 

I don’t know the last time I actually put my resume together, Tim but I think that would be something that you would want to do. It is a lot easier to kind of brush that up every year or so versus kind of cracking that open every decade. Are there – is there opportunities to pivot to consulting, to kind of work on your own? I think a lot of people paying attention to severance policies and negotiating benefits related to your career is going to be important. 

Another thing to kind of you know, mitigate the health stuff is maintaining a healthy lifestyle. So you know diet, weight, sleep, exercise, and potentially reducing stress by cutting back hours. So we kind of mentioned of like a glide path of going from a one to a point eight to a point six, you know to work in a couple of hours here and there. So I think that can potentially allow you to work part-time longer into retirement by maintaining a healthy lifestyle, maybe meditation, all that kind of stuff. 

The second work risk we talk about is re-employment risk. So this is the inability to supplement retirement income with employment due to kind of down job markets, poor health, or if you’re caring for others. So I think for my dad, you know when I happened to him you know I think it was hard for him because he had worked for the same company for 40 plus years to actually go into market and interview and do something else. 

So for him, it was kind of more about like comfortability and he really didn’t have anything else outside of that where he could consult or do part-time. Like I’ve heard people like drive a bus for a school and liking that because you know, they’re connected to kids or turning hobbies into profit-making activities. I was talking with my brother and his fiancé last night because we were actually talking about, “Hey, when do you want to retire, and when is that?” 

You know, one of the things that he brought up that I thought was interesting, he’s like, “I think I’d love to do like a bed and breakfast.” That’s cool. You know, he likes to cook, he likes to host, so I think that would be something that would be good for him. 

[0:32:37.3] TU: That is cool, yeah. 

[0:32:39.4] TB: Planning on earning significant income in retirement may be unrealistic for a lot of people. There are certain industries where it’s very easily, you can very easily kind of pivot to a consultant role and make just as much money as you would working full-time but that’s not necessarily the case for a lot of people. 

So I think kind of again, planning for this, talking through this, and understanding you know, what are some things that you can potentially lean on or pivot to in the event that what you thought was a short thing, which was like your employment is not so much and again, I think this often is one of those things where it’s like, “Hey, that’s not going to happen to me.” 

[0:33:25.4] TU: Yeah. 

[0:33:25.8] TB: I think this has probably evolved over time, right Tim? Because again, it’s rare where you find someone like my dad that’s worked for the same company for 40 or 45 years. So I think our eyes are a little bit more open to this risk but I think what maybe might not be is the fact that like, “Hey, your health or someone close to you” or something like that could affect your timeline, so to speak for retirement. 

[0:33:50.1] TU: Yeah, and as you’re talking Tim, I’m thinking about many people in our community of which many of them have been on the podcast where you know I think they may intentionally or unintentionally are preparing themselves for something like this and the risk you’re talking about, right? They’ve got you know, maybe they’re investing in real estate in a variety of ways, they’re working a full-time job. 

They’re doing some consulting, they’ve got a side hustle, they maintain an active network, you know, they’re constantly developing their skills, right? Just multiple strategies of diversification that I think help mitigate against some of the risks that you’re talking and maybe they’re not even thinking about it in that way, it’s coming from an area of energy and passion but it can be really helpful as we talk about strategies to plan for this type of risk. 

[0:34:33.3] TB: Yeah, absolutely. 

[0:34:35.0] TU: All right, number 10 on our list is family risk. Take us home, Tim. 

[0:34:41.4] TB: Yeah, so the two kind of sub-risk that we would talk here is kind of the loss of spouse risk and then unexpected family financial responsibility risk. So the loss of spouse essentially is where you know, I’ll use myself, I retire at 70. I think I’m going to live at least to 87 or 95 and I pass away unexpectedly at 72, right? So the problem often with that is you know, you’re often, for many spouses, you’re kind of known two social security income streams, right? 

You know, so one of those goes away, you keep the highest one but the problem – so you still have all of the assets. The spouse will inherit all the assets that are in their name obviously but what typically doesn’t reduce is a lot of like living expenses, right? So your food might go down but you’re still going to have to pay if you have a mortgage. 

[0:35:41.9] TU: Property taxes, yeah. 

[0:35:42.8] TB: Or you know, rent or things like that, tax, all of those, your utilities are going to be very similar. So just because your income or a good chunk of your income could be cut in half or even a third, your expenses don’t and what we’ve seen at least with baby boomers is that you could be a widow or a widower for 15 or 20 years. So it’s not like you know one and this happened where one spouse dies and the one will die within a year or two. 

I mean, but that does happen but you could have long periods of time where you’re by yourself. There was a stat that I saw that was really interesting Tim, was within five years of a death of a spouse, 40% of widows become impoverished. 

[0:36:29.9] TU: Wow. 

[0:36:31.1] TB: That’s insane to me and I think if I had to guess, I don’t know this Tim, but if I had to guess, I would think that that’s probably again, people that are lower income that might like a huge chunk of their livelihood is in disability. So if a good chunk or not, disability, social security, so a good chunk of that goes away, so you have two paychecks is now one, you know that could be very problematic for kind of sustainability of overall wealth.

But that to me was eye-opening and I’ve heard that before with husbands will say like, “I just want to make sure my wife is taken care of if I’m gone” and again, I don’t want to get into much of like gender roles and things like that. 

[0:37:17.4] TU: Sure. 

[0:37:17.8] TB: But I still think that that exists in a lot of relationships, particularly older couples where you know, one partner handles the money and the other one doesn’t or has an interest in the other one doesn’t. So you know I think the solution for this is and I’ve talked to people in the past is like, “I want a relationship with like an adviser where I trust them because even when I’m gone they’re going to take care of the person, you know, my spouse.” 

So I think having a relationship with that, with like a planner I think can be important. I think involvement, you know I often say this with couples of all ages, you know the more that you are involved with your plan. 

[0:38:00.6] TU: Absolutely, yes. 

[0:38:02.0] TB: And the more you are engaged with the plan like both of you, I think the better the results will be but I also understand that there’s some like, there’s some couples that there might be engagement in the front end and then maybe one spouse kind of you know drives the train after that but then often what happens is like again, if that spouse dies like they kind of have to reengage is necessarily like the easiest thing. 

So you know, what are the contingency plans if this were to happen? Even sometimes like when we – so if we were to say, “Hey Tim, you know we’re going to peel off a quarter million dollars of your portfolio to provide an income for you and Jess.” What’s attractive about those payoff schedules is like the one that just pays your lifetime is the highest but we would want to say, “Okay, let’s have a joint life payout.” So it would pay you as long as one of you are alive but that benefit is going to be lower. 

[0:38:54.8] TU: Yeah. 

[0:38:55.4] TB: So decisions like that, you know if you have second-to-die policies or you know again, social security claim, and there is a lot of people that they don’t look at the layers of that decision that says, “Okay, even if Tim is in poor health than Shay, if I have a larger benefit that I want to defer that I should defer, that benefit grows and then when I pass away, Shay takes that on.” 

So some of that, some of those nuances aren’t necessarily you know, evaluated. So those would all be things that you know again, it’s not just the abrupt, “Okay, the husband is gone or the wife is gone,” these are things that we have to bake into the plan as we go because you know, things like social security or you know, payouts and things like that have to be decided. So it’s not just the abrupt, “Okay, what happens once that happens in that moment?” 

It’s the multitude of decisions that you have to make potentially leading up to that and then lastly, it’s the unexpected financial responsibility risk. So this is kind of the risk of failure to launch, Tim. Like, “Hey, I’m 40 years old. I just lost my job” or “I’m divorced. I’m moving back in with mom and dad” or you know, care of a grandchild or because parents have problems with the law or drug addiction.

These things happen you know and sometimes, we can kind of put this thing in like a liquidity risk of like unanticipated events but I would say like those would be things that I would want as a planner to know like, “Is there a possibility for this and if this were to happen, what do we do?” 

[0:40:40.8] TU: Yeah. 

[0:40:41.3] TB: So that’s another you know, risk associated with family. Families can be great obviously but sometimes, you know that’s kind of my biggest fears. You know, I want to make sure that as I’m raising my kids and I know it’s the same, it’s true with you, Tim, like they can be contributing members of society that can you know, be self-sustaining but sometimes that’s even out of their hands, right? So we want to make sure that in the event that that happens, we can plan accordingly. 

[0:41:11.4] TU: Tim, as you talk about loss of spouse, a couple of things are coming up for me. One that’s timely, you know where Jess and I are working on, just updating your legacy folder that we created several years back but in our planning with Kelly from our team. You know, it’s a part of the process that we need to go back to and update it and you know to you comment about the importance of joint planning and all parties being involved ideally. 

Even in this situation where Jess and I feel like are both very well informed, I do take a little bit more of the lead but it is very much a shared agenda and execution and both of us engage with Kelly and the planning. You know, instructions on that legacy folder, while they’re spelled out as much as possible, you know for either one of us or in the event that both of us were to pass away, for our parents or whoever it be taking care of the finances and the boys, it’s, “Go call Kelly.”

Like someone we trust that knows this plan inside out, that has these documents, that understands all of the nuances and what is going on and that is so reassuring. Again, assumption is you have someone you trust. It’s so reassuring to know you’ve got a third party that not only is there to help you develop the plan but is there in the event of some of these challenging situations that may come up to make sure that we’re executing how we wanted it to be executed. 

[0:42:29.1] TB: Yeah, and I think what’s not covered in that like I love the idea of like, “Okay, Kelly is a safe haven. She has the documents, she knows your situation” I think it’s hugely, hugely important but I think what’s also not necessarily discussed in this is kind of like the emotional or social like you know, my parents were in town this week, last week and this week. It’s been cool because my brother has been in town too. So the three of us have been spending – my dad just turned 77. 

[0:43:04.9] TU: Baker pow-wow. 

[0:43:05.7] TB: Yeah, and we’re joking with my dad that like if mom passed away like I don’t think my dad knows how to do like a load of laundry. I love you Dad but he’s very much dependent on my mom over you know, decades and decades of marriage. If something were to happen to them like I think he would have to move in with one of us to live and I’m sure a lot of people are thinking about their parents and they’re like, “That’s my dad” or “That’s my mom.” 

You know, I think even that of the loss of spouse not just from a financial standpoint or like where are the documents or things like that, it’s kind of a day-to-day living in terms of like what am I doing or what can I do or what can I not do and who am I leaning on and you know, I think that kids are probably the first people that are in that role but I think like having those conversations before that happens where maybe there’s less emotion involved is smart. 

So it’s not just the numbers, it’s what’s the quality of life? What are the things that we’re going to do to move forward? And unfortunately, it is part of life and I think the more that you can kind of get in front of things just like anything else, I think the better result you’ll have. 

[0:44:28.6] TU: Yeah, the other thing to your point about the emotional journey that’s coming up is a throwback almost four years ago now but we had on episode 127, we had on Michelle Cooper, who wrote the book, I’ve Still Got Me: A Widow’s Journey to Love, Happiness & Financial Independence, lost her husband to suicide and talks about not only the importance of joint planning and shared understanding of processes and documentation but also navigating that in the midst of that emotional loss. 

Great interview, great resource. We’ll link to that in the show notes as well. Tim, this has been fantastic as we’ve covered in two episodes now 10 of these risks we need to be planning for and mitigating the best that we can. For folks that are listening, you know you heard a theme here of early planning. Obviously, we would love to have the opportunity to talk with you if you are interested in working more with one-on-one with a financial planner that you can trust. 

We’ve got a team of fee-only certified financial planners, tax professionals that work with pharmacists households all across the country at all stages of their career. You can learn more by going to yfpplanning.com and you can book a free discovery call from that site. Again, yfpplanning.com. Tim Baker, as always, great stuff. Thanks for the contribution. 

[0:45:41.4] TB: Yeah, thanks, Tim. 

[DISCLAIMER]

[0:45:42.4] TU: As we conclude this week’s podcast, an important reminder that the content on this show is provided to you for informational purposes only and it is not intended to provide and should not be relied on for investment or any other advice. Information on the podcast and corresponding materials should not be construed as a solicitation or offer to buy or sell any investment or related financial products. We urge listeners to consult with a financial advisor with respect to any investment. 

Furthermore, the information contained in our archived newsletters, blog posts, and podcasts is not updated and may not be accurate at the time you listen to it on the podcast. Opinions and analyses expressed herein are solely those of Your Financial Pharmacist unless otherwise noted and constitute judgments as of the dates published. Such information may contain forward-looking statements, which are not intended to be guarantees of future events. Actual results could differ materially from those anticipated in the forward-looking statements. For more information, please visit yourfinancialpharmacist.com/disclaimer. 

 

Thank you again for your support of the Your Financial Pharmacist Podcast. Have a great rest of your week.

[END]

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YFP 324: Retirement Roadblocks: Identifying and Managing 10 Common Risks (Part 1)


On this episode, sponsored by First Horizon, YFP Co-Founder and CEO, Tim Ulbrich, PharmD and YFP Co-Founder and Director of Planning, Tim Baker, CFP®, RLP®, RICP®, kick off a two-part series on 10 common retirement risks you should plan for.

Episode Summary

While a lot of emphasis is placed on the accumulation phase when preparing for retirement, there is considerably less focus on simple strategies for turning assets into retirement paychecks, for example. This week, Tim Ulbrich and Tim Baker kick off a two-part series on 10 of the most common retirement risks you should be planning for. Today, Tim and Tim cover five of these risks, including longevity risk, inflation risk, excess withdrawal risk, unexpected health care risk, and long-term care risk. You’ll find out why thinking about retirement as “half-time” is a good idea, the different options for taking out annuity payments, and why it is important to think about your withdrawal strategy, as well as what a bond ladder is and why you should consider unexpected medical expenses. Whether you are nearing retirement or are still in the accumulation phase, this episode is full of valuable insights. 

Key Points From the Episode

  • Introducing our two-part series: 10 Common Retirement Risks to Plan For.
  • Background on why this topic is so important. 
  • A couple of important disclaimers before we dive into the first risk: longevity risk.
  • Viewing your retirement as half-time.
  • Setting realistic expectations and planning as best as you can.
  • Lifetime income: a careful analysis of Social Security claims and strategies.
  • Options for taking out annuity payments.
  • Thinking about your withdrawal strategy to mitigate longevity risk.
  • The risk associated with inflation.
  • Defining what a bond ladder is.
  • Why social security is one of the most important things to evaluate in retirement.
  • How higher rates of inflation have influenced Tim and the planning team’s models.
  • Whether or not there should be a glide path from a work perspective.
  • Excess withdrawal risk: depleting your portfolio before you die.
  • A quick recap of the bucket strategy.
  • Healthcare risk: facing an increase in unexpected medical expenses in retirement.
  • Different Medicare plans: Part A, B, C, D, and Medicare Advantage plan.
  • Long-term care risks, misconceptions, and potential solutions.
  • The tough conversations we need to have. 

Episode Highlights

“You get to the end of the rainbow and you have hundreds of thousands of dollars, millions of dollars. The question is how do you turn these buckets of assets into a sustainable paycheck for an unknown period of time?” — @TimBakerCFP  [0:04:02]

“Longevity risk is the risk that a retiree will live longer than – they expect to. What this really requires is a larger stream of lifetime income.” — @TimBakerCFP [0:06:48]

“There’s a whole other race to run after your career.” — @TimBakerCFP [0:09:44]

“The more flexible you can be with your withdrawal rate, the greater the portfolio sustainability will be.” — @TimBakerCFP [0:18:15]

“Essentially, in retirement, inflation could erode your standard of living.” — @TimBakerCFP [0:21:57]

“Abrupt retirement sounds sweet, but in reality, it’s really hard.” — @TimBakerCFP [0:29:37]

“It’s less about the actual return and more about the sequence of when that return comes that can affect the sustainability of [your] portfolio.” — @TimBakerCFP [0:35:55]

“You don’t want to get to a point where you’re having to go through the courts to get the care that your loved ones need. If you can avoid that at all costs, even if it means having an uncomfortable conversation – I think it’s needed.” — @TimBakerCFP [0:48:07]

Links Mentioned in Today’s Episode

Episode Transcript

[INTRODUCTION]

[0:00:00] TU: Hey, everybody. Tim Ulbrich here, and thank you for listening to the YFP Podcast, where each week we strive to inspire and encourage you on your path towards achieving financial freedom. This week, Tim Baker and I kick off a two-part episode on 10 Common Retirement Risks to Plan For.

When planning for retirement, so much attention is given to the accumulation phase, but what doesn’t get a lot of press is how to turn those assets into a retirement paycheck for an unknown period of time. When building a plan to deploy your assets during retirement, it’s important to consider various risks to either mitigate or avoid altogether. That’s what we’re discussing during this two-part series, where today we cover the first five common retirement risks, including longevity risk, inflation risk, excess withdrawal risk, unexpected health care risk, and long-term care risk.

Now, make sure to download our free guide that accompanies this series, that guide being the 10 common retirement risks to plan for, and you can get that at yourfinancialpharmacist.com/retirementrisks. This guide covers the 10 common retirement risks you should consider and 20-plus solutions on how to mitigate these risks. Again, you can download that guide at yourfinancialpharmacist.com/retirementrisks.

All right, let’s hear from today’s sponsor, First Horizon, and then we’ll jump into my conversation with YFP Co-founder and Director of Financial Planning, Tim Baker.

[SPONSOR MESSAGE]

[0:01:24] ANNOUNCER: Does saving 20% for a down payment on a home feel like an uphill battle? It’s no secret that pharmacists have a lot of competing financial priorities, including high student loan debt, meaning that saving 20% for a down payment on a home may take years. We’ve been on a hunt for a solution for pharmacists that are ready to purchase a home loan with a lower down payment and are happy to have found that option with First Horizon.

First Horizon offers a professional home loan option, AKA doctor or pharmacist home loan that requires a 3% down payment for a single-family home, or townhome for first-time home buyers, has no BMI, and offers a 30-year fixed rate mortgage on home loans up to $726,200. The pharmacist home loan is available in all states, except Alaska and Hawaii, and can be used to purchase condos as well, however, rates may be higher and a condo review has to be completed.

To check out the requirements for First Horizon’s pharmacist home loan and to start the pre-approval process, visit yourfinancialpharmacist.com/home-loan. Again, that’s yourfinancialpharmacist.com/home-loan.

[EPISODE]

[0:02:36] TU: Tim Baker, welcome back to the show.

[0:02:38] TB: Good to be back, Tim. How’s it going?

[0:02:39] TU: It is going. We have an exciting two-part series planned for our listeners on 10 common retirement risks to avoid. I think as we were planning for this session, just a lot of depth and great content, that we want to make sure we do it justice, so we’re going to take five of these common retirement risks here in this episode. We’ll take the other five next week. Tim, just for some quick background, one of the things we’ve talked about on the show before is so much attention is given when it comes to retirement, is given to the accumulation phase as we’re saving, especially for those that are maybe a little bit earlier in their career.

It’s save, save, save. But I even think for all pharmacists in general, that tends to be the focus, but we don’t often think about, what does that withdrawal look like, both in the strategy, which we talked about on the show previously, but also in what could be some of the risks that we’re trying to mitigate and avoid. Just give us some quick background on why this topic is so important as we get ready to jump into these 10 common mistakes.

[0:03:39] TB: Yeah, I think to your point, I think a lot of the, even the curriculum in the CFP board standards is very much focused on the accumulation phase of wealth building. I think there’s a lot of challenges and a lot of risks that you have to deal with during that phase of life and during that phase of wealth building. But I think what doesn’t get a lot of the press is like, okay, you get to the end of the rainbow and you have hundreds of thousands of dollars, millions of dollars. The question is, how do you return these buckets of assets into a sustainable paycheck for an unknown period of time?

While navigating a lot of these risks, I don’t know if it’s risk avoidance, Tim. I think it’s just planning for the risk. We’re talking about avoiding risk. Some of these, you can’t really avoid. You just have to plan for it. I think that what we’re finding is, I think the whole general rule of like, “Oh, I’ll get to the end and I’ll have a million dollars and I’ll put 4%, $40,000 a year for the rest of my life.” There are a lot of pitfalls to that. I think that hopefully, this discussion shines a light on some of that. I think it is just important because we think that the – the hard part is, hey, I just need to put assets aside, but I think equally as hard as, okay, how do I actually deploy these assets for a wealthy life for myself in retirement?

[0:05:04] TU:  Yeah, good clarification, right? Some of these, as we talked through the 10. Avoidance isn’t necessarily possible. It’s the planning for, it’s the mitigation, minimizing the impact, however, we want to say it. I think, what you articulated is just spot on, right? I think when it comes to retirement planning, saving for the future, we tend to view that nest egg number, whatever that number is, 3, 4, 5 million dollars, whatever is the finish line. So many other layers to consider there.

Not only getting there, which again, we’ve talked about on the show previously, and we’ll link to some of those episodes in the show notes and the strategies to do so, but how do you maintain the integrity of that portfolio? How do you optimize the withdrawal of that portfolio? If we’re doing the hard work throughout one’s career to be saving along the way, we want to do everything we can to get as much juice out of that as possible.

That’s the background as we get ready to talk through some of these 10 common retirement risks to plan for. Just a couple of important disclaimers; We’re not going to talk about every retirement risk that’s out there, of course, Tim, so there’s certainly more than 10. You’ll notice them overlap as we go through these. This is not meant to be an all-encompassing list. Of course, this is not advice, right? We obviously advocate that our listeners work with a planner, no matter what stage of your career that you’re in to be able to customize this part of the plan to your personal situation.

For folks that are interested in learning more about our one-on-one financial planning services, our team of certified financial planners and tax professionals, you can go to yfpplanning.com and book a free discovery call to learn more about that service.

All right, Tim. Let’s jump off with number one, which is longevity risk. What is that risk? Then we’ll go from there and talk about some potential solutions.

[0:06:48] TB: Longevity risk is the risk that a retiree will live longer than what they expect to. What this really requires is a larger stream of lifetime income. We’ll talk about that in a second. The hard part about this whole calculation, Tim, is that there are lots of unknown variables. Unfortunately, or fortunately, I guess the way – depends on how you look at it, I don’t know when I’m going to pass away. Social Security obviously has a good idea of what that is. When I was preparing for this episode, Tim, I looked at, I went onto socialsecurity.gov, and put in my – basically, my gender and my birthday. It comes back with a table and it doesn’t factor in things like health, lifestyle, or family history. But it essentially says that for me at 40 – oh, man, it’s tough to look at that, Tim. 40 years old in 10 months, that my estimated total years, I’m halfway there.

[0:07:47] TU: Halfway. I was going to say. Yeah.

[0:07:49] TB: I’m 81.6. Now, once you get to age 62, then it starts to go out. At age 62, it says I’m going to live to 85. If I make it age 67, then it says, hey, I’m going to live to 86 and change. Then at age 70, which is when I think I’m going to retire, Tim. That’s my plan, at age 70, 87.1 years. I think that for a lot of people, this is an unknown. I overlay like, okay, when did my grandparents pass away and things like that.

Some general stats, one in four will live past age 90 and one in 10 will live past age 95. I think these stats fly a bit in the face of Social Security, but maybe not. I think they factor some of this in. One of the big discussions that we have in our community is like, what should we plan to? What should we plan to? Should it be age 90? Should it be to age 100? We default to 95, which is right in the middle. For me, being in my 40s, it says 87.1-years-old.

I think, this unpredictable length of time really puts a huge unknown out there in terms of like, okay, because there’s a big difference between I retire at age 70 and I pass away at 87. That’s 17 years of essentially, senior unemployment retirement. Or if I live to 100, which is another 13 years. It’s huge. I saw a visual table recently, not to go on too much of a tangent, but it was like, your youth and then your college years was – If you imagine a square, was a shade on the square and then your career and then your retirement and your career and retirement in this visual were pretty close.

[0:09:33] TU: Which we don’t think about it like that, or I don’t, at least.

[0:09:36] TB: No, I don’t either. But I saw that. I’m almost eyeballing them, like, they’re pretty close. People think of like, “Oh, rat race and things like that,” but there’s a whole other race to run after your career. I think we overlooked the time on that. I do think that people will, because especially with a lot of the economic things people may be joining the workforce later, starting families later, maybe starting to save later, we’re living longer that it could push everything to the right a little bit. I think that could be one of the things that they do with Social Security is that maybe we don’t get our for retirement age of 67, then we get the for all credits at 70. Maybe they push those back a little bit. But it’s still a long time, Tim, is what I’m saying.

[0:10:23] TU: Yeah. It really is. As you’re sharing, Tim, it reminded me of a great interview I had with a retired dean and faculty member, Dave Zgarrick on episode 291. He talked about exactly what you’re saying in terms of that timeline perception. He was really encouraging our listeners to reframe your retirement date as essentially, half-time, right? We’ve got some opportunities to reset, reframe, and figure out, but it’s not the end of the game. There’s a whole other half that needs to be played. Obviously, here, we’re talking about making sure that we’re financially prepared for it, but there’s certainly much more to be considered than just the financial side of this as well.

I think the piece here that really jumps out to me, Tim, when people think about longevity risk is there’s really a lot of fear that I sense from individuals of – and the last thing I want to do is run out of money. I don’t want to be a burden to my family members. I really want to make sure I plan for this. The challenge, I think, here is there’s a balance to be had, right? We also don’t want to get to the end of our life and we’ve been sitting on this massive amount of money that maybe it’s been at the expense of living experiences along the way. I think this is just a really hard thing to plan for. To your point, I think a general number is a good place to start. So much of this literature on longevity comes down to family history, lifestyle, and other things that are going to help inform this.

[0:11:44] TB: I don’t think that you can – oftentimes, when we work with particularly younger pharmacists, we’ll get to a point and they’re like, “Hey, I got it from here. I’m good.” It’s almost like, they chunk the next five or 10 years of their life is autopilot. I always be – if I look back at the last five or 10 years of my life, it’s been anything but that. What I would say to, even in retirement, you have to take it year by year and you have to assess this year by year. I think, hitting the easy button and saying, okay, for the next five or 10 years, it’s going to be like this, is not great for your plan, right?

I think that’s probably if we talk solutions, we’re probably going to say this on repeat with a lot of these is like, you have to plan for this as best you can. Whether it’s set in a realistic expectation. For me, I think it would be irresponsible for me to say like, okay, 87 years old. I’m going to retire at 70, have set – and again, we’ll talk about this, too, is I might not retire at 70. I might have to retire a lot sooner than that. If I say, “Hey, 70.” Then I have to plan for 17 years, I think that would be really irresponsible. I think, set in realistic expectations in terms of life expectancy. Consider personal and family health history.

I think, you do pay a price, Tim, for a longer plan horizon, to your point, because you need more resources, which means that you have to save potentially more in your accumulation phase. Then when you’re in retirement, you have to be more conservative with what you’re withdrawing. That could lead to, again, you forgoing things today for a longer future, I guess, or being all sustained. That’s definitely one thing. It’s just, how do you best plan for that longevity?

[0:13:32] TU: You know, the other thing that’s coming up for me, Tim, as you’re just sharing this solution around planning for longevity is if folks end up erring on the side of your example, right? Social Security says one number. Maybe we’re planning 10 years further than that. Then there’s an interesting – certainly, you’re mitigating one risk, but you’re also presenting another risk, which is potentially having excess cash at the end of life, which obviously, there has to be planning done for that. What does that mean for the transfer of assets? Is there philanthropic giving that’s happening?

Then there’s a whole tax layer to that as well, right? In terms of, how are the taxes treated on that if we’re planning, perhaps, to not die was zero, but we may have additional funds that are there at the end of life. Just another great example, I think, of where financial planning comes together with the tax plan, and obviously, everyone’s situation is going to be different.

[0:14:21] TB: Another solution that would bring up for this risk, Tim, would be lifetime income. This is where I think, really a careful analysis of Social Security claims and strategies is needed. Because I think a lot of people, they’re like, “Okay, I’m 62. I’m eligible for my Social Security. I think, my parents died at 80. Probably going to die right there.” There’s a lot of things that I think we just blow through. One of the biggest retirement decisions is just going to be this decision on how and when you’re going to claim. Social security is a lifetime income. If you start claiming at 62, you’ll get that until you pass away. Start claiming at 70, and you’ll get a much greater benefit until you pass away.

There are not very many sources of income like that. Pensions might be another thing, but that would be one of the things that we would want to make sure that if we need X per month, or per year, a good percentage that is lifetime income, meaning not necessarily out of your portfolio, on a 401k.

Another way to do this is to transfer the risk of longevity to an insurance company by purchasing something like an annuity, so you can provide protection from the risk of dying young by purchasing a term certain. You could say, “Hey, I want this annuity to pay me for a lifetime and I’ll get a lesser amount, or for the next 10 years and I might get a higher amount.” But a lot of people are really not crazy about that, because they could give an insurance company $100,000 and then get one or two payments and die the next month or whatever. There are refund riders and things like that, so I think looking at that is something that definitely in the lifetime income.

I think, one of the things that people don’t know of, is if you have a 401k, a lot of people, they’ll take a lump sum and they might put it into an IRA. One of the things that you could do is take annuity payments for life out of that plan. What they essentially do is go out, most of the time they go out and buy an annuity for you. That’s a way to do it, instead of taking a lump sum, you can buy, basically, annuity payments from a 401k, that type of 403b. You can get lifetime income from insurance contracts, so cash value, life insurance, death benefit, there’s an annuity option.

This can even be true for a term policy. If I pass away and shay, most times will elect a lump sum, but you can say, “Hey, I want this payment for life, or for X amount of years.” Those securities are probably going to be the biggest ones, but then an annuity or something like that would probably be a close second to provide lifetime income for you to negate some of the longevity risks that’s there in retirement.

[0:17:04] TU: Yeah, a couple of resources I want to point our listeners to episodes 294, 295, you and I covered 10 common social security mistakes to avoid, along with a primer we did back on episode 242 of Social Security 101. Really reinforces what Tim’s talking about right here. Then we covered annuities on episode 305, which was our understanding of annuities, a primer for pharmacists. Certainly, go back and check out those resources in more detail. Probably lots of avenues to consider, but any other big potential solutions as people are trying to mitigate this longevity risk?

[0:17:37] TB: I think, probably the last one, and I mean, there are others, but probably the last big one I would bring up is probably, what is your withdrawal strategy? We’ve mentioned the rule of thumb of 4%, but I think that’s limited in a lot of ways. One is a lot of those studies are based on a finite number of years, i.e. 30 years from age 65 to 95, and we know that people are living beyond that 30 years that that’s been planned. That’s one thing.

For longer periods, the sustainable withdrawal rate should be reduced, but typically, only slightly. What’s left out of that, the 4% study is flexibility. The more flexible you can be with your withdrawal rate, the greater the portfolio sustainability will be. When the portfolio is down, and you can withdraw less, that allows you to sustain the portfolio a lot longer. Then, I think, the other thing that’s often overlooked with this is that typically, and we’ll talk about sequence risk, but typically, once you get through that eye of the storm retirement risk zone, you want to start putting more equities back into your portfolio.

I think, just the proper allocation strategy, which is where you’re considering portfolio returns, inflation, what your need is, what your flexibility is. Again, I think that becomes a lot easier, or palatable if you have, say, an income floor, or if you have a higher percentage of your paycheck coming from Social Security. All of these things are kind of, just like systems of the body are intertwined, but just your withdrawal strategy and allowing for that to sustain you for a lifetime is going to be very, very important along with some of the other things that we mentioned.

[0:19:19] TU: Yeah. Tim, I think there are a couple of things there that are really important to emphasize, that I think we tend to overlook when it comes to the withdrawal strategy. One of which you mentioned was that flexibility, or the option to be flexible on what you need. When we show some of these examples, we just assume, hey, somebody’s going to take a 3%, or 4% withdrawal every year, but depending on other sources of income, you’ve mentioned several opportunities here, depending on other buckets that they have saved, right? That flexibility may, or may not be there, which ultimately, is going to allow for us to be able to maximize and optimize that even further. All right, so that’s number one, longevity risk.

Number two is inflation risk. Tim, I think this is probably something that maybe three, four, five years ago, people were asking, hey, what inflation? Obviously, we’re living this every day right now. We’ve seen some extremes, although our parents would say, we ain’t seen nothing yet from what they saw growing up. What is the risk here as it relates to inflation?

[0:20:16] TB: We’re going to talk about inflation a few times in this series. What we’re talking about with regard to this risk is this is really the risk that prices of goods and services increase over time, right? The analogy or the story I always give when I talk about investments is that the $4 latte that you might get from Starbucks in 2020, 30 years might be $10, $11, or $12. If you look back at, I would encourage a lot of people that, hey, I had a conversation like this with my parents like, “What did you buy our house back in New Jersey?” I think they said, it was $41,000.

Now, when they – because they were – we were talking about what we bought our house at and the interest rates are like, it’s unbelievable. They don’t understand. I think this is a huge thing, especially with retirees, you’re thinking, or you’re dealing with a fixed income, more or less. The larger percentage of your income that’s protected against inflation, which social security is, which is another reason that it’s also very valuable is because it’s lifetime, but then basically, it gets adjusted by the CPI.

When you work, Tim, inflation is often offset by increases in salary, right? The employer has to keep pace as best they can –

[0:21:42] TU: Hopefully. Yeah.

[0:21:43] TB: Yeah. Or they’ll lose talent. In retirement, inflation reduces your purchasing power, so you don’t have an employer to raise. Now, like I said, you can think of social security like that, because they’re going to do that adjustment every year. But essentially, in retirement, inflation could essentially erode your standard of living.

Again, the first solution here is to plan for this. I would throw taxes in here, but even inflation is often overlooked in terms of like, how do we project these numbers out? What is a realistic estimate of inflation over the long term? I would encourage you, again, I’m a financial planner, so I’m biased, but I think using software and accounting for inflation almost by category of expense. We know that things like medical expenses, and the inflation for medical expenses is going to outpace a lot of other things, whether it’s fuel, utilities, or food, that type of thing.

That would be the big thing. I think overlaying some type of inflation assumption into your projections and seeing how that affects your portfolio, your paycheck is going to be super important. Another solution to this, Tim, would be going back to longevity. We talked about lifetime income. I’m going to say, not necessarily lifetime income, but inflation and adjust in income. Social Security, again, is the best of this. That we saw last year, I think it was – someone might have to correct me. It was like, 9% year over year. That’s pretty good.

If you were to buy an annuity, a lot of insurance companies won’t offer a CPI rider. They might say, “Hey, your payment in your annuity, you can buy a rider, which is going to cost a lot of money,” that it says, it’ll go a flat 2% or 3%. The insurance companies are not going to risk saying, “Okay, it’s with whatever the CPI is, because they’re not going to be able to price that accordingly.” Inflation-adjusted income.

Some employer-sponsored plans, like a pension, could offer some type of COLA increase. This is more typical in government pensions, government plans than it is with private plans. Like I said, you can purchase a life annuity with a cost-of-living rider, but it’s typically very limited and very, very expensive. You might get, for kicks, Tim, these are just round numbers. You might say, “Hey, give me straight up $1,000 as my benefit.” But if I add a, COLA rider, or something like that, it could cut it down to $800. Again, that’s not real numbers. That could be the cost there.

Then the last thing for this is to build a bond ladder using tips. A bond ladder is essentially, and we could probably do a whole episode on this, Tim, but a bond ladder would be, hey, basically, I want to build 10 years of income, say. Let’s say, I’m retiring in 2024, or let’s say, 2025. My first bond ladder might come due at the end of 2024. Then that’s going to give me $30,000 or $40,000. At the end of 2025, going in 2026, the second run of my bond ladder is going to pay me and basically, do that for the next 10 years.

Then essentially, what you do is you try to extend that ladder out. You might go to year 11, might go to year 12 as you’re spending that down. A good way to do that is with tips, which is an inflation security, an inflation-protected security. That’s one way to inoculate yourself from the inflation risk.

[0:25:14] TU: I looked up Social Security while you were talking there, you’re spot on. 8.7% in 2023. Yeah, that’s significant, right? I think especially for many folks and hopefully, as our listeners are planning, that won’t be as big of a percentage of the bucket for retirement. The data shows that across the country, it really is.

[0:25:33] TB: Yeah. I think, again, I think, when we’ve gone back to my own, it was something like, if I claimed at 62, I have to remember the numbers. If I claimed that 62, my benefit would be $2,500. If I claim at 70, I think it’s over $4,000.

[0:25:49] TU: Something like that. Yeah.

[0:25:50] TB: But then, if you then tack on the inflation on that, it’s just huge. Again, I think, that is going to be one of the most important things that you evaluate in retirement is the social security stuff.

[0:26:01] TU: One of the other thoughts that have gone to mind, Tim, as you were talking with inflation is just rates of return. We tend to, at least on a simple high level, right? We think of rates of return and a very consistent 7% per year. We know the markets don’t obviously act like that. We have huge ups, huge downs. We’re seeing that with inflation as well, right? We tend to project 2%, 2.50%, and 3%. But we lived in a period where inflation was really low. Obviously, we’re now seeing that bump up. My question for you is, as you beat this up with the planning team like, has this period of high inflation, at least higher than what we’ve seen in our lifetime, has that changed at all? Some of the modeling, or scenarios that you guys are doing long term?

[0:26:42] TB: I think, we’ve ticked it up a bit. I definitely think it’s probably too soon to say like, hey, for the next 30 years, we got to go from 3%, which has typically been the rule of thumb, to 5%. I think as we get a little bit further from quantitative ease in and putting a lot more money in circulation and we’re seeing the result of that, that I do see some modification of models and that’s going to be needed.

One of the things that the government and the Fed try to do is keep inflation at that 3%. I just don’t know if they’re going to be able to – the new norm might be keeping it as close to 4%, or 5%, right? I would say for me, and again, I try to keep on this as best I can, but I think for me, I think it’s a little too soon to tell. To your point, the reality is that I would say, less so for inflation, because I think there is a little bit of the thumbs on the scale with the government and the Fed, but we do see fluctuations in market returns. We’re seeing now more fluctuation in inflation.

I think, a lot of what I’m reading is that we’re probably at pretty much the end of rates going up. But I’m interested to see is like, okay, when they start to potentially reverse, or normalize, what is the new normal? I think if you put as much money in circulation as we have, I think this is one of the side effects, and we’re paying for that now.

[0:28:15] TU: The thing that’s coming to mind here as you’re talking about inflation risk and even tied to longevity risk is we often assume retirement is a clean break, right? You were working full-time, you’re no longer working full-time. For many folks, either based on interest, passion, or financial reasons, there could very well be some type of part-time work, right? Whether that’s consulting, whether that’s part-time PRN work, or whatever. To me, that’s another tool you have in your tool belt, when you talk about inflationary periods, or what’s happening in the market and whether or not we need to draw from those funds. Having some additional income, if you’re able and interested, could be an important piece of this puzzle.

[0:28:57] TB: We often think of a glide path in retirement. Meaning that, the closer we get to retirement, the less stocks we have, the more bonds we have, safety, that type of thing. I think, we have to start talking more about a glide path, like a work perspective, where you go from 1 to 0.8 to 0.6 to 0.2, or whatever. Then maybe, it’s just 10.99 PRN, or something like that. This is for a variety of reasons. It’s for the reasons that you mentioned market forces, and inflationary forces, I think even more so for mental health.

[0:29:29] TU: Mental health. Yeah, absolutely.

[0:29:31] TB: IR, like we talk about our identity and role and things like that and a soft landing. I think, abrupt retirement sounds sweet, but I think in reality, I think it’s really hard for, if you’ve been in the workforce for 30 years and there might be people that are like, “Nope. You’re crazy, Tim.” I talked about this and some retirees will probably roll their eyes. When I took my sabbatical, it was just a month, right? It wasn’t a ton of time. I literally was like “All right, I’m not going to touch work.” I’m like, “What am I doing?”

I guess, my thought process was I could see how it could be where you’re directionless, right? I spent a lot of time planning for just that month and I’m like, it was an interesting test case for me to be like, all right, I just need to make sure that when I’m positioning myself, I still have availability for meaningful work and other interests and things like that. Yeah. I mean, everything that you read is that the best thing to combat a lot of these risks is actually not to retire. It’s to work or work at a reduced – If you’re working and you’re not drawing on your portfolio, then problem solved. Obviously, we know that’s not necessarily the best solution.

I think, having the ability to do that, there’s from a mental health perspective and a lot of these other reasons. I think pharmacists in particular are positioned with their clinical knowledge and things to do things with their PharmD that provide value in retirement and that are not necessarily stressful, or strenuous. So — 

[0:31:04] TU: Yeah, I think that feeling of contribution is so important. I just listened to a podcast this week with Dr. Peter T on one of my favorite podcasts, The Huberman Lab Podcast, and he was talking exactly about longevity and some of the risks to longevity in that context of mental health. He was talking about the value of contribution, the value of work. I think for all of us, it’s natural in those moments and seasons of stress. That feeling of contribution can get overlooked, right? I mean, I think it’s a natural thing to feel. Really, really good discussion. I think, it highlights well. We’re obviously talking about X’s and O’s in terms of dollars. But when it comes to retirement planning, so much more than that.

Number three, Tim, we talked briefly about, but we can put a bow on this one, would be excess withdrawal risk. Tell us more here.

[0:31:52] TB: Yeah. This is really just that you’re withdrawing at a rate from the portfolio that will deplete the portfolio before you die. Which is one of the biggest fears and one of the biggest risks is like, “Hey, I just want to make sure that I have enough money to last me throughout retirement.” I think, the biggest thing again for this is to have a plan, have a strategy and be flexible with that plan.

There are ways that you can build your retirement paycheck, and we’ve talked about this before, where it’s coming from a variety of sources. At the end of the day, there is still going to be a portion of your paycheck, the retiree, you are pulling the string. You’re saying, “Okay, I’m going to get X amount from Social Security, potentially X amount from maybe a floor, an annuity, but then the 60%, or whatever it is has to come from these buckets that I’ve filled in the accumulation phase.” Like I said, the default that a lot of people use is, hey, it’s the 4% rule. There are other strategies, like [inaudible 0:32:54], guardrails that are more, look at market forces, look at inflation, and then basically, adjust your portion of your paycheck accordingly.

If you do that consistently and you stick to that plan, you’ll basically see the portfolio sustained for 30-plus years. I think that’s probably the big thing that in all the research says is that if you can adapt your spending, which is hard, right? It’s hard for us to do that in the accumulation. It’s often hard for us to do that in retirement, but if you can adapt your spending with the ride the roller coaster of market volatility inflation, it lands in sustainability. We’ve also talked in the past about the bucketing strategy. You make sure that you have the next five years, basically, in very CDs, money markets, very safe investments. Then that allows you to inoculate, at least for the next five years to do more mid-risk type of investments. Then for those 15-plus years, more risky investments with regard to the portfolio.

The bucketing strategy is just a take on the systemic withdrawal strategy but allows the retiree to understand more and compartmentalize and say, “Okay, if I have the next five years planned out, if I need 40,000 times five years, I had that in that bucket. I don’t really care what the market does. If the market goes down today, I know that in most cases, it’s going to recover in the next three and a half, four years and we’re good to go.”

Again, a lot of people, I think will say, “All right, well, this year, regardless of what’s going on in the world, I need this. Then the next year –” Then they wake up and they’re like, “Man, I had a million dollars, seven years in retirement, I have 200,000 left. This is no bueno.”

[0:34:51] TU: Yeah. Another important point you’re bringing up here and you mentioned earlier in the show, I think we tend to oversimplify, especially when we’re thinking accumulation of, “Hey, I’m going to save two, three, four million dollars. Maybe I’m going to be moderately aggressive, or aggressive. Then I retire.” We don’t think about what is the aggressive to moderate to non-aggressive strategies of investing in retirement, right? We’re not taking a portfolio of two, three, four million dollars, and also just moving it into something that’s liquid. We still have to take some calculated risks, to your point earlier, that we’ve got potentially a long horizon in front of us.

Tim, what I think about is the double whammy of potentially, when you retire, which depending on where the markets are, you may or may not have control of that. I think about people that may have retired pre-pandemic, not knowing what was coming and then the markets did their thing. The double whammy I’m referring to is if you retire and start withdrawing at a period where the market’s down significantly and you’re dependent on that draw, we’ve got a double effect of what we’re getting hit there.

[0:35:52] TB: Yeah. We’ll get into more of that in the sequence risk, in terms of, it’s less about the actual return and more about the sequence of when that return comes. That can affect, basically, the sustainability of that portfolio.

[0:36:06] TU: Since you mentioned the buckets and building retirement paycheck, as you call that, we did cover that previously, episode 275. We’ll link to that in the show notes. That was one of four episodes that we did, 272 through 275 on retirement planning. All right, so that is number three, excess withdrawal risk. Tim, number four on our list is unexpected healthcare risk. Tell us more here.

[0:36:29] TB: Yeah. This is the one we haven’t really covered much. We probably should give it a little TLC, maybe in future episodes. I think that Medicare and the decisions around Medicare is also another huge decision to make in retirement. This is the risk of facing an increase in unexpected medical expenses in retirement. One of the things that people often get wrong is that it’s like, okay, I qualified for Medicare at 65, I’m good. All my medical costs will be taken care of. That’s not true.

The decision of when to enroll and whether to choose the original Medicare or Medicare Advantage plan, choosing the right Part D plan for drug prescription is really going to be important. The figures, they’re not overly impressive, Tim. In 2019, they said, the average male at age 65 is going to spend about $79,000 to cover medical, or healthcare costs in retirement.

[0:37:25] TU: That’s lower than I would have thought, to be honest.

[0:37:26] TB: Yeah. Now, I think it goes out – I mean, again, you can see for if you look at the tables, what did it say for me at 65? I was going to live to – does it have at 62 to 67. Let’s say, it’s another 20 years. Yeah, it seems low to me. I mean, females, age 65 is a lot more, a $114,000 to cover healthcare expenses in retirement. It doesn’t seem a lot in terms of your – it is outside of housing. It’s going to be one of the bigger things, especially when you’re in the phase of older retirement.

I think, probably the default here is how – it goes back to planning and understanding what’s available to you. I think, choosing the appropriate insurance is going to be important. One of the things, and we’ll talk about this in the next for us, but a lot of people think that long-term care is covered by Medicare. It’s not. Another thing that a lot of people don’t know is that Medicare doesn’t have a cap on out-of-pocket expenses. If you have large amounts of medical expenses, you could be paying in perpetuity, that’s where a supplemental plan, or a Medigap plan will be important.

Part A, to break these down, covers a lot of hospital visits and inpatient stuff. Part B is more, I think, outpatient, like covers medical necessary services, like doctors, service and tests, outpatient care, home health services, durable medical equipment, and that type of thing. Then part C is going to be the drug. Then there’s going to be lots of variations of part D. Then what people then assess, Tim, is, should I get a supplemental plan, or a Medicare advantage, which is not to say under traditional Medicare, but it’s more of a reimbursement through a private medical, or private insurance company.

This is one that I think that is often overlooked. It’s hard because every state and area of the country is going to be different. What you can get if you’re a resident of Florida is going to be different if you’re a resident of New Jersey or Ohio. I think, going through this and probably on an annual to reassess is going to be an important part of making sure that you’re mitigating, as much as you can, the risks of those increased, or unexpected medical expenses while retired.

[0:39:44] TU: A couple of things are coming up for me, Tim, here. Obviously, one would be, if we’re factoring this into the overall portfolio nest egg. Certainly, that’s one strategy. The other thing I’m thinking about, if folks have access to an HSA and are able to save in that long term, without needing those for expenses today. Obviously, if you need them, you use them. That’s what it’s there for. If not, the opportunity is for these to grow and to invest and invest in a tax-free manner, such that it could be used for six-figure expenses right in retirement.

We’ve got an exciting – October is all going to be about healthcare insurance costs. We’re going to have several episodes all throughout the month. One of which is going to be focused on Medicare. We’re also going to be talking about healthcare insurance for those that are self-employed. Then we’ll be talking about open enrollment, other topics as well. Looking forward to that, that series that we’re going to do in October.

Tim, number five on our list, which will wrap up our part one of this two-part series is long-term care risk. Now, we did talk about long-term care insurance previously on the show. That was episode 296, five key decisions for long-term care insurance. You just mentioned not something that Medicare is going to cover. Tell us about this risk and potential solutions.

[0:40:56] TB: Yeah. This is the risk of essentially, not being able to care for oneself. It basically leaves you dependent on others to perform, or help you perform the activities of daily living. These ADLs are called activities of daily living, are bathing, showering, getting dressed, being able to get in and out of bed, or in and out of a chair, walking, using the bathroom, and eating.

Typically, if you need help with two or more of these things, this is typically where a long-term care insurance policy will actually trigger. These could be cause for a variety. It could be chronic diseases, orthopedic problems. Alzheimer’s is probably the biggest one that is the biggest threat for this particular risk. Planning for this is huge. It’s funny, Tim, because – not funny, but it’s interesting is that this is one of the risks where it’s like, it’s not me, right? It’s someone else. Most people see this as an important thing to plan for, but not necessarily for themselves.

The reality of the situation is that in most cases, family members will provide the care, which is about 80% of the time in the home, which is unpaid care, averaging about 20 hours per week. If you imagine that, Tim, if that were laid at your feet, how that could affect your health, your finances, just your career. That’s the effect that it has on the family. Like I said, most people think that Medicare covers long-term care costs. It doesn’t. Many people think that this is a risk, or a concern in retirement, but not necessarily for them, it’s for somebody else.

I think, one of the misconception is like, if you look at things like insurance, a lot of people think, “Hey, it’s too expensive.” In that, I think, that reputation is probably earned, because I think when they first priced these policies, when they first came out, there were a lot of policies that were not priced expensive, or the right way, so they got more expensive year over year. There was a study that said that less than 10% of people that were age 65 and older had long-term care.

Really, the need is not as long as you think. The average time that a male needs long-term care is about a little bit more than two years. For females, a little bit less than four years. Solutions for this is plan for this. Understand what are the risks and costs associated with it. Again, every state is going to be different in terms of what these costs and what is the cost for something like, anything from being able to age in place and have care given in your home, to a nursing home. Understand, what is that in your area? How do you want to pay for long-term care? I mean, how do you want that care delivered?

A big part of this is just getting organized with, okay, if this were to happen, where can we get this money from? Is it insurance policy that we purchased? Is it family members? Is it something like a reverse mortgage? Are there government programs, like if you’re a veteran, there’s some programs for that. Could be Medicaid. That is a program that’s probably the largest funding source of long-term care, but you have to be impoverished to do so. A lot of people will purposely spend down their estate to become impoverished, to get care, which there’s a lot of hoops and things that you have to be careful of.

But insurance is probably, and I know we did an episode on this is like, that’s another one to really look at is when to purchase a lot of people, we should really start talking about this in late 40s and purchase in your 50s. I think 55 is the average, if I’m not mistaken. If you wait longer than that, Tim, that’s when you have increased instances of the coverage being denied and it gets really expensive. You have to thread that needle a bit. What is the amount needed? 

I think at a minimum, we should be pricing and we say, okay, for us to be able to age in place, so have someone come in 20 hours a week, five days a week, or whatever that looks like, is that $3,000? Is at $6,000? Find that number and be able – A lot of the study says, the longer that you can stay in your home and not in a facility, the better. What’s the amount? Is that inflation-protected? What’s the elimination period? Is it a straight-up long-term care insurance plan? Or is it linked to an annuity purchase or a life insurance purchase?

Or if you go through all that, you’re like, “You know what? I got this and we sell fund, which is probably the most popular sell fund with the family as ad hoc caregivers.” Unfortunately, I think that’s really more of a lack of planning than anything. But that is a solution as well to say, okay, if that’s the case, again, looking at funding sources and things like that. This is another thing that I think is often overlooked, because, I think, some of the misconceptions about long-term care. But if you can get a policy that pays you $3,000, $4,000, $5,000 a month for care, to be able to stay in the home, I think for a variety of reasons, that’s worth looking into.

[0:45:57] TU: Yeah, Tim. I agree. I think that this is often overlooked, perhaps from a misunderstanding, or evaluating the risk. The other thing that comes up for me often here is just the difficult conversations that need to be had to really navigate this. We just, a few episodes had back on the show, Cameron Huddleston, who is just fantastic. She wrote, Mom and Dad, We Need to Talk, how do you navigate difficult financial conversations with parents? Some listening to this are thinking about it for themselves, certainly. Others may be working with aging parents and trying to navigate these conversations.

Who wants to initiate a conversation of, “Hey, Mom and Dad, what are you doing for long-term care insurance?” Or, maybe that age window has passed, where a policy makes sense. Now, we’re back to, okay, what’s the game plan? What does this look like financially? What does this look like in terms of the ability of our time to be able to care and care well? I think, there’s just a lot to navigate here that is not just financial, but that is emotional as well. She does a great job in that book, in the episode, we just recorded as well, of how do you initiate these conversations in a loving and respectful way? But more than anything, to get out in front of the planning. Again, whether you’re planning for yourself, whether you’re planning for aging parents, so important to be thinking about this.

[0:47:14] TB: This is a little teaser into our next few risks that we’ll cover in the next episode, in terms of just tough conversations that need to be had, so we can prevent things happening in the future. It’s just a byproduct of old age and being able to care for oneself. That can be hard to broach those subjects with your children, even adult children. There’s some vulnerability. I think, just the way you approach that, and obviously, people have different relationships with parents, and some people are really close. Some people brought up in a house where you don’t talk about money, you don’t talk about some of these things. It can be really hard.

I think, one of the things that really stuck with me with Cameron’s work and her writings is like, you don’t want to get to a point where you’re having to go through the courts to get the care that your loved ones need. If you can avoid that at all costs, even it means having an uncomfortable conversation, or maybe it’s not a conversation, maybe it’s a letter to break the ice and you go from there, I think it’s needed.

[0:48:25] TU: Yeah. Whether it’s the courts, or in her instance, and we’re going through this right now with my grandmother as well. But in Cameron’s instance, she had a mom who is struggling with memory loss and Alzheimer’s that her message, and one of her main messages, hey, you want these conversations and planning that be happening before those instances are in question, where you’re now dealing with more challenges of, is someone in the right state of mind to be able to make those decisions, and what are the legal implications of that?

Great stuff, Tim. That is five of the 10 common retirement risks to plan for. We’re going to be bringing the rest of this list back on the next episode, so make sure to join us here next week. Of course, for folks that are listening to this and thinking, “Hey, it’d be really helpful to have someone in my corner that really can help me plan for retirement, as well as other parts of the financial plan,” we’d love to have a conversation with you to have you learn more about our one-on-one fee-only financial planning services, as well as to learn more about your individual plan and the goals that you have. You can book a free discovery call by going to yfpplanning.com. Again, that’s yfpplanning.com. All right, we’ll see you next week.

[END OF EPISODE]

[0:49:33] TU: Before we wrap up today’s show, I want to again thank this week’s sponsor of the Your Financial Pharmacists Podcast, First Horizon. We’re glad to have found a solution for pharmacists that are unable to save 20% for a down payment on a home. A lot of pharmacists in the YFP community have taken advantage of First Horizon’s pharmacist home loan, which requires a 3% down payment for a single-family home, or townhome for first-time home buyers and has no BMI on a 30-year fixed-rate mortgage.

To learn more about the requirements for First Horizon’s pharmacist home loan and to get started with the pre-approval process, you can visit yourfinancialpharmacist.com/home-loan. Again, that’s yourfinancialpharmacist.com/home-loan.

[DISCLAIMER]

[0:50:18] TU: As we conclude this week’s podcast, an important reminder that the content on this show is provided to you for informational purposes only and is not intended to provide and should not be relied on for investment, or any other advice. Information on the podcast and corresponding materials should not be construed as a solicitation, or offer to buy, or sell any investment, or related financial products.

We urge listeners to consult with a financial advisor with respect to any investment. Furthermore, the information contained in our archive, newsletters, blog posts, and podcasts is not updated and may not be accurate at the time you listen to it on the podcast. Opinions and analyses expressed herein are solely those of your financial pharmacists, unless otherwise noted, and constitute judgments as of the dates published. Such information may contain forward-looking statements, which are not intended to be guarantees of future events. Actual results could differ materially from those anticipated in the forward-looking statements.

For more information, please visit yourfinancialpharmacist.com/disclaimer. Thank you again for your support of the Your Financial Pharmacist Podcast. Have a great rest of your week.

[END]

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