Interview with Dr. Lara Hochman
This week, we discover that the Medical Matchmaker has a traditional solution for burnout: joining the right medical group.
Dr. Lara Hochman is a Family Medicine physician. She graduated from the University of Texas School of Medicine and finished her family medicine residency at St. Anthony North Hospital in Oklahoma City.
Solving the Burnout Problem
Dr. Lara Hochman is the “Medical Matchmaker.” She fights to protect the wellness of her medical colleagues in the face of escalating burnout and unhappiness. Her own experiences inspired her to research how physicians lose their autonomy and how they might regain their commitment to treating patients.
In order to connect physicians with successful, physician-owned private practices where they can once again enjoy practicing medicine, she launched Happy Day Health, a boutique physician-matching business.
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Happy Day Health Services
Dr. Hochman loved medicine but detested the healthcare system. So, she founded her company to provide a remedy for the burnout it produces. She steps in to act as a medical matchmaker, connecting doctors to physician-owned practices.
Happy Day Health assists physicians in locating practices that closely reflect their personal and professional values. In the process, it helps practices find physicians. Dr. Hochman also provides advice to physicians about creating their resumés, understanding their contracts, and preparing for interviews.
Building the Medical Matchmaker Business
During the interview, Lara describes how starting a business requires accepting uncertainty and learning as you go. In medicine, we are taught to aim for perfection and spend many years learning the rules. In business, however, it is sometimes necessary to learn on the fly, make mistakes, and course-correct as needed along the way.
This process can be exhausting and emotionally distressing, but it will lead to a point where you feel confident in what you're doing. By following your instincts, and maintaining a commitment to make a difference you find satisfaction and encouragement to keep going.
Challenges for Physicians Going ‘Private'
When comparing private practice with hospital-based practices, salary is often the driving factor that influences a physician's selection. But that can be short-sighted. In a small practice, you have an opportunity to be a decision-maker. And the long-term benefits of autonomy and becoming an owner should be considered.
Working with and for other physicians is a much more collegial situation. It is less likely to create an inflexible corporate environment driven by patient volumes and the need to push downstream revenues.
Dr. Hochman's Advice
When it comes to salary… it can actually potentially be much higher in private practice. You just have to be able to delay gratification a little bit longer… Also, if you find a practice that you feel will treat you well and pay you a salary that you're happy with, do it. Don't wait.
Summary
Dr. Lara Hochman has dedicated herself to connecting physicians with private practices run by other physicians. In the process, she is helping to prevent and overcome the burnout that occurs when working in a high-volume corporate environment. And by doing so, she overcome her own disappointment in the U.S. healthcare system and discovered her purpose.
NOTE: Look below for a transcript of today's episode.
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Links for Today's Episode:
- Happy Day Health
- Dr. Lara Hochman's LinkedIn Page
- How to Save Healthcare, Satisfy Patients, and Fix Physician Burnout – 256
- Who Can Help When Private Practice Matters? – 174
- NewScr!pt
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Transcription PNC Podcast Episode 273
How the Medical Matchmaker Provides a Solution to Burnout
- Interview with Dr. Lara Hochman
John: In the town that I work in, well, I still work here, but when I used to practice here, both hospitals, small town outside of Chicago, I would see these groups come and go where a physician would hire a partner and then they'd leave after two or three years. And it's really uncommon to find a really well-run practice. But I have a friend who's a gastroenterologist, he's got eight partners. They've had a practice who's going for over 30 years and it just runs so well. And they have no trouble recruiting and they're all happy. They like what they're doing. So that's what we're going to talk about today.
Now we normally talk about nonclinical jobs or careers, but one of the principles I go by is that I think physicians should be happy, and I believe in physicians working for other physicians as opposed to working for corporations. So, with that, I want to welcome today's guest. Hello, Dr. Lara Hochman.
Dr. Lara Hochman: Hi. Thank you so much for having me today.
John: You're welcome. Yeah, this is not going to be about a nonclinical job. This is how to find a clinical job where you can be happy and fulfilled and wake up in the morning and actually look forward to going to work. So, tell me and our listeners here who you are, what you do, and maybe a little bit about your background.
Dr. Lara Hochman: Sure. I'm the medical matchmaker. I help physicians find practices that will really closely align with their value systems. And on the flip side, I also help practices find physicians. And then throughout that process I really help out with a lot of kind of coaching through what to talk about in the interview, all of those things. Negotiation, all that stuff.
I'm a family medicine physician. I still practice. I do locum tenens here where I work, where I live locally. And that's because I actually still love medicine. I do this in large part because I personally have been burned out and thought I hated clinical medicine and left medicine entirely thinking I was going to figure out what else to do. And then just this seemingly perfect job felt in my lap. It was terrifying because I was like, "But I don't like medicine anymore."
I decided to just take a risk and do it and figured out that I loved medicine. It was just the system I hated. I see that over and over again in so many people and I would like to be a part of the solution. I think once you're past the point of no return, then of course, clinical medicine may not be for you anymore. But there's so many of us that love clinical medicine and love everything. We just don't like the system. So, I'm out there to try to change it.
John: That's fantastic. Now when I think of clinical situations that physicians might enjoy, I do think about locums because although it's hard to necessarily set it up initially, it actually provides a lot of options and flexibility and so forth. I think of DPC and concierge care. But obviously, I also know of people, as I mentioned in the opening, that are working in jobs that they like because they have partners that they like. They have a practice that works well, the patients like them, and they're actually practicing traditional medicine even though we're in a system that tends to not favor that. Definitely I like to hear stories like this about someone who's doing the matchmaking.
So, how did you make that transition? It is difficult to start a new career and starting a new business is very challenging. So just a little bit about how you overcame some of the mindset issues and did you have to deal with family and say "Here's what I'm going to do." How did that come about?
Dr. Lara Hochman: Oh, my goodness. That is such a big question. Yeah, it was very interesting. There were parts of my family that I thought would be supportive that weren't, and there were parts that I thought would not be supportive and were. So, it's interesting. I think overall they accept and support me in what I'm doing. They're there to cheer me on and to pet my back when I'm feeling down. But it really was a challenge. There are no words for how difficult it was. It puts medical school to shame.
John: Oh, really?
Dr. Lara Hochman: And it's a different type of difficult. Medical school is like this firehose of information. This was more "I taught myself how to do what I'm doing." I had no training in business, no training in I would say traditional recruiting. I don't consider myself a recruiter, but I didn't know how to find people. I'm not a salesperson. All those things that I have no idea.
I was teaching myself something how to do something very difficult. I don't often feel comfortable talking to new people. And so, here I am calling complete strangers. I've learned a lot of what to do and what not to do and what I can deal with. But talking to strangers is tough and that's a huge part of what I do.
There were so many challenges and the financial part of starting a business is just... There's a lot. The first thing that I did was even just deciding to start the company. There was a lot of mind drama that I was having about it. I never wanted to be a business person. I never wanted to start a business. I'm a physician at heart, that's what I love. I never saw myself doing this. I actively did not want to do it. But I just felt there was so much that needed to be done for physicians. And so, that kind of mission of trying to be a part of the solution really just overtook that. And it turns out I actually love it. This was such a nice surprise.
I would say the first step, even before I started a business, I've been working on facing my fears for years in other ways. And so, that probably helped as a precursor. In medicine, we're trained to do what we're told, we're trained to follow the steps and study what we need to study. And so, that was a big shift in "I'm going to do what I'm going to do, and there's no blueprint for it."
That was really interesting. Like most people that probably are listening right now, I'm a total perfectionist. I don't like to do something unless I already know how to do it, which you can't do in entrepreneurship. Someone once said, not even to me, it was in a conference, they said, "Start before you're ready." And I was like, "Oh my gosh, okay, I'm not ready. I'm starting." And I started that day.
John: Nice.
Dr. Lara Hochman: That was huge. And realizing that I'm going to do it imperfectly, and that's okay and I have to make mistakes in order to be better, that was okay too. All of the mistakes I've learned from. And there was a period of time, near the beginning, where I would sit down every morning, and have a big old cry. It was so hard. And then I was like, "Okay, what's bothering me?" And then I'd kind of think through "I don't know how to do this" or "I'm having a challenge with that."
I would actually take that. I was so drained and emotionally sad and I would just take that and turn it into, "Okay. Well, obviously something is not working. Let me see what I can fix." And it was lots of little changes over time that I had to figure out what to do. I think I will be figuring it out till the day I die. But it's gotten to the point now that I'm so much more comfortable with what I'm doing. I've figured out so many things and it's satisfying. I'm so satisfied with being able to create real change and affect lives and have an impact far greater than I could if I were still just seeing patients myself, which I still love doing.
John: Nice. A couple of observations. When you have such a principle or a passion, whatever you want to call it, something you're committed to, that can push you through the end a lot of times. So, that's awesome. And you said you were teaching yourself. Well, you had a great student because you're a physician. You've already demonstrated your ability to solve problems and research things and read and learn. That's one thing we forget. Yeah, if we go through med school and residency, we can certainly learn how to start a business if that's our desire. And I do think it's definitely needed.
Now I have interviewed several people that had startups of various sorts. Some were selling products, but typically the ones that are doing more of a service are connecting, are usually connecting one person to another. They tried to start a locums company, recruiting company or some other type. And it's always a chicken and egg because you're doing the recruiting on both ends at the same time. You need physicians who are looking for a job and then you need the companies that are looking for physicians. Was that a challenge for you or did you find a simple solution to solving that problem? How did that come about? Where did you start on that part of it?
Dr. Lara Hochman: Yes, that will probably be my biggest challenge always. Because my whole business is predicated on finding people and speaking to people. It came from putting myself out there just saying, "Hey, this is what I do." I was one of those people who wasn't on social media. I don't like my face in public. I'm a very, very private person. Sort of. I'm an open book, you can ask me anything, but at the same time, I was never that person. Just putting myself out there and letting people know what I do was big. Something that I'm still learning to do is tell people, "Hey, tell other people about me. Do you have friends? I can help you. I can help your friends." That was really important and still is. Going out and meeting as many people as possible is part of my job. And I actually love that. I may be shy on the inside, but I'm actually an extrovert. I love being around people.
John: Okay, nice. Now what kind of things do you look forward in a practice? Or do you have some way of knowing that "Okay, since I'm promoting that I'm going to match somebody with a practice where they're going to be very happy?" Are there certain characteristics of those practices that hopefully will at least try to ensure that there's going to be a good fit? There are always personalities and so forth, but just give us your take on that.
Dr. Lara Hochman: Yeah, the first thing that I look for in a practice, even deciding if we're going to work together or not, is how I feel that they would treat their physician. A part of it is "are they financially stable?" Does it make sense financially for them to hire someone? Because if they can't, then you have a physician who maybe even moves cross country to work there and then they close their practice or they're not happy, you're not able to be paid. That's scary. Making sure they're financially stable is super important.
And then of course, just as important to that is the feeling that I get on how they will treat their doctors. A lot of it is what they say and what they're looking for. And a part of it is when they talk about "I want someone to be happy here." The kind of person that would really fit well as someone who is comfortable. Whatever it is. I want to hear from them why it's good working for them and I hear such great things. And of course, not everyone is going to be happy in every other environment. What is perfect for you would be different from what's perfect for me is different from what's perfect to the people listening. It's not necessarily that I'm looking for a specific thing other than I feel like they are going to be valued and have a voice and really cared for in a way and respected. Those are the main things I look for.
John: Are you able to find out what kind of turnover there has been at some of these practices? I suppose if they're pretty large, you can just ask around. Because to me that would be evidence of it. That's what I was talking about as I was introducing you, is that I've known many groups here where I am with one or two doctors to hire and they're just turning through them every two years because what they do is they treat them like residents. They never really talk seriously about partnership. And so, I figured they're always going to be a failure, but there's this other group that is very stable. So, is it possible to kind of get that information and to kind of key some of your decisions on that?
Dr. Lara Hochman: Yeah, that's huge. I think the biggest way of knowing if a practice will treat you well is how many doctors have come and gone. A lot of the practices that I work with are just single-physician practices that are ready to expand. I'm not going to get a good sense of if the physicians have come and gone. But I do get a sense of how they talk about their practice, how they talk about what they're looking for, how they talk about the kind of person that they would be to work with, and the rest of their staff turnover.
One of the practices I'm working with now, it's a single physician. She's had her practice for 12 years and she's looking for a true partner. She's looking for someone who will bring ideas and who will not just be a partner financially and business side, but really come up with their own ideas and be a part of running the practice. And her employees have been there six years or longer. More than likely, she's going to treat her physician well if she treats the rest of the office staff well.
John: Absolutely. Well, let's see. We've seen in general over the last decade or two or longer, migration to more employment with large corporations, hospitals, health systems and so forth. Which brings me to the next question. The reason for that is it seems like they have more money sloshing around and they can buy your practice or they can recruit you even if things don't work out and they end up firing you in two years, they have you tied in.
So, what kind of things do you tell your clients, the physicians, in terms of what to expect when they're looking for a job like this? And are they going to have to take that into consideration that they might benefit on this side, but maybe the monetary will be later? How does that work?
Dr. Lara Hochman: Yeah. And before I even go into that, I'll say that different physicians are at a different point of being able to hear that, like truly hear that or be open to that. That conversation isn't really important to them. When it comes to hospital versus private practice, I would say probably the biggest one that affects people is salary. We forget that we are still in a business. The practices that we're working for still have to make money. The smaller practices are putting a lot of money into.
The physician owners actually don't take a salary while they pay you your salary versus the hospitals who are getting money from the imaging and the labs and the referrals and all the things that they do. And some of them are hiring people who will order more of those tests and make more money and that's where your salary is coming from. So, they are happy to lose money on the clinic visits themselves because they know they're going to make it up in all these other ways. I do hear from physicians, "I just want to be paid fairly" without a true understanding of what that actually means.
One of the downsides of private practice is that it's a smaller system and this could be a benefit, pro or a con being smaller, but one of the cons is that it doesn't have those large systems set up to be able to provide these giant salaries and amazing health insurance benefits and paid time off. But with that, that's what we call the golden handcuffs. So, you go work for these systems and you get used to be paying whatever salary it is that you're used to, and then you feel like you can't leave no matter how they treat you.
That's one of the most important things that I see, I see doctors who go work for hospitals and maybe have an idea going into it that they're not going to be so happy, or it's wonderful, but then administration changes and it's time for them to get out of it because they're just miserable.
The biggest thing is to really prepare for those circumstances. That means not signing a non-compete where you wouldn't be able to work in the city you live in if you were to leave them.
If there is a non-compete, there has to be a way to get out of it. If they fire you, maybe the non-compete is void or you can have what's called a sunrise or a sunset close on your non-compete where it's not valid after a certain number of years working there. There needs to be some sort of wiggle room so that when you sign that contract with the hospital, you have a way of leaving them. Because they know that they've got us, they have us. We are not leaving because they're giving us the salary, they're giving us the time off and the health insurance and all these things that are amazing. And if we leave, we have to leave town. They don't care about us. If they actually cared about their physicians as human beings and medicine in general, and patients, they wouldn't be doing these things. They'd be retaining us by treating us well rather than retaining us by not giving us a choice otherwise.
John: No, that's absolutely true. And it's a reason you need to have a good attorney look at these contracts because there's usually some wiggle room. But if you don't even ask, you're not going to get the concessions. It's a really good point.
The other thing that I've seen in the past when I was working as a CMO is we would try to put the onus for the malpractice sometimes, or at least part of it on the physician. If they left after a year or two, they were going to be subject to tail coverage or something like that, which I've come to believe that's just ridiculous because it's a cost of doing business. If they won't do that, you shouldn't even consider working with an institution like that because again, it's the worst of the handcuffs and it's not fair.
Given that though, you might have to go with a private partner and what have you. The income at first might not be as high as what's published by hospitals, but long term you're going to be a lot happier and have a lot more satisfaction. Let me pause here, by the way. Give us your website address right now so I don't forget. Some people don't listen all the way to the end. So, we're going to find Happy Day Health where?
Dr. Lara Hochman: It's happydayhealth.co. And you can find me on LinkedIn as well. It's Lara Hochman MD.
John: Okay. We'll put that in the show notes and we'll talk about that again at the end here. Have you gotten any feedback from people that you've placed with these practices? Have you heard back from how things are going three, six months in?
Dr. Lara Hochman: Yeah, they're doing great. They're so happy. One guy said I saved his life, and there are no words for that. They're just happy and they're like, "I didn't realize, I had no idea what I was missing" or "Thank you for opening my eyes up to." I had a DBC recently, "Thank you for opening my eyes to DBC." Even a physician who I didn't place has said, "Thank you so much. You've changed the way I practice. You've changed the way I look for practices." So, it's a lot of fun. It's very rewarding and doctors are just happier. Some of these were physicians who were considering leaving medicine entirely and they're really enjoying it.
John: Any general advice now? Because someone who's been in practice has been burned out, they know they're looking for something different. But let's say you're coming out of residency and you really don't know, and again, you're going to be pulled into that funnel, you're going to see all these ads. Other advice or just things that they should think about a little bit before necessarily ruling out one of these potentially lower-paying but more life-affirming positions?
Dr. Lara Hochman: Yeah. Oh, my gosh. I have so many things to say. When it comes to salary, the few things to know are to look at the starting salary and the potential earnings because it can actually potentially be much higher in private practice. You just have to be able to delay gratification a little bit longer. Also, especially for the new grads, I see very frequently where doctors want to interview at so many different places and then in the process, they may actually lose the perfect job where they know it's the one they want, but we're not used to making decisions and so we overanalyze it and take too much time and then can lose that.
I would say if you find a practice that you feel will treat you well and pay you a salary that you're happy with, do it. Don't wait. You don't want to lose out on something awesome because you were just kind of all over the place.
And I understand if you've never worked in a practice before as an attending, then how do you know what you're looking for? But as long as you protect yourself like we spoke about with a non-compete and all of those things, then you're good. But yeah, I would say pick the practice that will treat you the best because life is a journey. We're not racing to retirement. You want to enjoy every day.
John: Maybe if you're a resident or fellow and you're coming out and you've been in an academic situation or something, maybe you need to spend a little bit of time just talking to a couple of people who are in private practice as opposed to maybe everyone who's surrounded and they're in an academic practice or they're in a large hospital practice. Maybe talk to a few of those people that have been by themselves or in a small group or even a large group that's run by doctors. Maybe that'll give them a little insight into trying to make those decisions. Because you're right. It's easy to fall into that thing of just going with the higher salary and the upfront benefits, but later on you might regret it.
Dr. Lara Hochman: Yeah.
John: All right. Again, the website is happydayhealth.co. They can reach you, Dr. Lara Hochman on LinkedIn. I think this is really exciting. I hope you all the success. You need to keep us posted. Even if you want to do a little recruiting here, let me know. I'll put the word out if you're really having a hard time finding somebody because I'm sure some of my listeners are like, "Yeah, nice practice is just as good a way to solve burnout as becoming an MSL or something." Anyway, it's been my pleasure talking to you and I really appreciate you coming on the podcast today.
Dr. Lara Hochman: Yeah, thank you so much for having me.
John: Okay, you're welcome. Bye-bye.
Dr. Lara Hochman: Bye.
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Transcription PNC Podcast Episode 273
How the Medical Matchmaker Provides a Solution to Burnout
- Interview with Dr. Lara Hochman
John: In the town that I work in, well, I still work here, but when I used to practice here, both hospitals, small town outside of Chicago, I would see these groups come and go where a physician would hire a partner and then they'd leave after two or three years. And it's really uncommon to find a really well-run practice. But I have a friend who's a gastroenterologist, he's got eight partners. They've had a practice who's going for over 30 years and it just runs so well. And they have no trouble recruiting and they're all happy. They like what they're doing. So that's what we're going to talk about today.
Now we normally talk about nonclinical jobs or careers, but one of the principles I go by is that I think physicians should be happy, and I believe in physicians working for other physicians as opposed to working for corporations. So, with that, I want to welcome today's guest. Hello, Dr. Lara Hochman.
Dr. Lara Hochman: Hi. Thank you so much for having me today.
John: You're welcome. Yeah, this is not going to be about a nonclinical job. This is how to find a clinical job where you can be happy and fulfilled and wake up in the morning and actually look forward to going to work. So, tell me and our listeners here who you are, what you do, and maybe a little bit about your background.
Dr. Lara Hochman: Sure. I'm the medical matchmaker. I help physicians find practices that will really closely align with their value systems. And on the flip side, I also help practices find physicians. And then throughout that process I really help out with a lot of kind of coaching through what to talk about in the interview, all of those things. Negotiation, all that stuff.
I'm a family medicine physician. I still practice. I do locum tenens here where I work, where I live locally. And that's because I actually still love medicine. I do this in large part because I personally have been burned out and thought I hated clinical medicine and left medicine entirely thinking I was going to figure out what else to do. And then just this seemingly perfect job felt in my lap. It was terrifying because I was like, "But I don't like medicine anymore."
I decided to just take a risk and do it and figured out that I loved medicine. It was just the system I hated. I see that over and over again in so many people and I would like to be a part of the solution. I think once you're past the point of no return, then of course, clinical medicine may not be for you anymore. But there's so many of us that love clinical medicine and love everything. We just don't like the system. So, I'm out there to try to change it.
John: That's fantastic. Now when I think of clinical situations that physicians might enjoy, I do think about locums because although it's hard to necessarily set it up initially, it actually provides a lot of options and flexibility and so forth. I think of DPC and concierge care. But obviously, I also know of people, as I mentioned in the opening, that are working in jobs that they like because they have partners that they like. They have a practice that works well, the patients like them, and they're actually practicing traditional medicine even though we're in a system that tends to not favor that. Definitely I like to hear stories like this about someone who's doing the matchmaking.
So, how did you make that transition? It is difficult to start a new career and starting a new business is very challenging. So just a little bit about how you overcame some of the mindset issues and did you have to deal with family and say "Here's what I'm going to do." How did that come about?
Dr. Lara Hochman: Oh, my goodness. That is such a big question. Yeah, it was very interesting. There were parts of my family that I thought would be supportive that weren't, and there were parts that I thought would not be supportive and were. So, it's interesting. I think overall they accept and support me in what I'm doing. They're there to cheer me on and to pet my back when I'm feeling down. But it really was a challenge. There are no words for how difficult it was. It puts medical school to shame.
John: Oh, really?
Dr. Lara Hochman: And it's a different type of difficult. Medical school is like this firehose of information. This was more "I taught myself how to do what I'm doing." I had no training in business, no training in I would say traditional recruiting. I don't consider myself a recruiter, but I didn't know how to find people. I'm not a salesperson. All those things that I have no idea.
I was teaching myself something how to do something very difficult. I don't often feel comfortable talking to new people. And so, here I am calling complete strangers. I've learned a lot of what to do and what not to do and what I can deal with. But talking to strangers is tough and that's a huge part of what I do.
There were so many challenges and the financial part of starting a business is just... There's a lot. The first thing that I did was even just deciding to start the company. There was a lot of mind drama that I was having about it. I never wanted to be a business person. I never wanted to start a business. I'm a physician at heart, that's what I love. I never saw myself doing this. I actively did not want to do it. But I just felt there was so much that needed to be done for physicians. And so, that kind of mission of trying to be a part of the solution really just overtook that. And it turns out I actually love it. This was such a nice surprise.
I would say the first step, even before I started a business, I've been working on facing my fears for years in other ways. And so, that probably helped as a precursor. In medicine, we're trained to do what we're told, we're trained to follow the steps and study what we need to study. And so, that was a big shift in "I'm going to do what I'm going to do, and there's no blueprint for it."
That was really interesting. Like most people that probably are listening right now, I'm a total perfectionist. I don't like to do something unless I already know how to do it, which you can't do in entrepreneurship. Someone once said, not even to me, it was in a conference, they said, "Start before you're ready." And I was like, "Oh my gosh, okay, I'm not ready. I'm starting." And I started that day.
John: Nice.
Dr. Lara Hochman: That was huge. And realizing that I'm going to do it imperfectly, and that's okay and I have to make mistakes in order to be better, that was okay too. All of the mistakes I've learned from. And there was a period of time, near the beginning, where I would sit down every morning, and have a big old cry. It was so hard. And then I was like, "Okay, what's bothering me?" And then I'd kind of think through "I don't know how to do this" or "I'm having a challenge with that."
I would actually take that. I was so drained and emotionally sad and I would just take that and turn it into, "Okay. Well, obviously something is not working. Let me see what I can fix." And it was lots of little changes over time that I had to figure out what to do. I think I will be figuring it out till the day I die. But it's gotten to the point now that I'm so much more comfortable with what I'm doing. I've figured out so many things and it's satisfying. I'm so satisfied with being able to create real change and affect lives and have an impact far greater than I could if I were still just seeing patients myself, which I still love doing.
John: Nice. A couple of observations. When you have such a principle or a passion, whatever you want to call it, something you're committed to, that can push you through the end a lot of times. So, that's awesome. And you said you were teaching yourself. Well, you had a great student because you're a physician. You've already demonstrated your ability to solve problems and research things and read and learn. That's one thing we forget. Yeah, if we go through med school and residency, we can certainly learn how to start a business if that's our desire. And I do think it's definitely needed.
Now I have interviewed several people that had startups of various sorts. Some were selling products, but typically the ones that are doing more of a service are connecting, are usually connecting one person to another. They tried to start a locums company, recruiting company or some other type. And it's always a chicken and egg because you're doing the recruiting on both ends at the same time. You need physicians who are looking for a job and then you need the companies that are looking for physicians. Was that a challenge for you or did you find a simple solution to solving that problem? How did that come about? Where did you start on that part of it?
Dr. Lara Hochman: Yes, that will probably be my biggest challenge always. Because my whole business is predicated on finding people and speaking to people. It came from putting myself out there just saying, "Hey, this is what I do." I was one of those people who wasn't on social media. I don't like my face in public. I'm a very, very private person. Sort of. I'm an open book, you can ask me anything, but at the same time, I was never that person. Just putting myself out there and letting people know what I do was big. Something that I'm still learning to do is tell people, "Hey, tell other people about me. Do you have friends? I can help you. I can help your friends." That was really important and still is. Going out and meeting as many people as possible is part of my job. And I actually love that. I may be shy on the inside, but I'm actually an extrovert. I love being around people.
John: Okay, nice. Now what kind of things do you look forward in a practice? Or do you have some way of knowing that "Okay, since I'm promoting that I'm going to match somebody with a practice where they're going to be very happy?" Are there certain characteristics of those practices that hopefully will at least try to ensure that there's going to be a good fit? There are always personalities and so forth, but just give us your take on that.
Dr. Lara Hochman: Yeah, the first thing that I look for in a practice, even deciding if we're going to work together or not, is how I feel that they would treat their physician. A part of it is "are they financially stable?" Does it make sense financially for them to hire someone? Because if they can't, then you have a physician who maybe even moves cross country to work there and then they close their practice or they're not happy, you're not able to be paid. That's scary. Making sure they're financially stable is super important.
And then of course, just as important to that is the feeling that I get on how they will treat their doctors. A lot of it is what they say and what they're looking for. And a part of it is when they talk about "I want someone to be happy here." The kind of person that would really fit well as someone who is comfortable. Whatever it is. I want to hear from them why it's good working for them and I hear such great things. And of course, not everyone is going to be happy in every other environment. What is perfect for you would be different from what's perfect for me is different from what's perfect to the people listening. It's not necessarily that I'm looking for a specific thing other than I feel like they are going to be valued and have a voice and really cared for in a way and respected. Those are the main things I look for.
John: Are you able to find out what kind of turnover there has been at some of these practices? I suppose if they're pretty large, you can just ask around. Because to me that would be evidence of it. That's what I was talking about as I was introducing you, is that I've known many groups here where I am with one or two doctors to hire and they're just turning through them every two years because what they do is they treat them like residents. They never really talk seriously about partnership. And so, I figured they're always going to be a failure, but there's this other group that is very stable. So, is it possible to kind of get that information and to kind of key some of your decisions on that?
Dr. Lara Hochman: Yeah, that's huge. I think the biggest way of knowing if a practice will treat you well is how many doctors have come and gone. A lot of the practices that I work with are just single-physician practices that are ready to expand. I'm not going to get a good sense of if the physicians have come and gone. But I do get a sense of how they talk about their practice, how they talk about what they're looking for, how they talk about the kind of person that they would be to work with, and the rest of their staff turnover.
One of the practices I'm working with now, it's a single physician. She's had her practice for 12 years and she's looking for a true partner. She's looking for someone who will bring ideas and who will not just be a partner financially and business side, but really come up with their own ideas and be a part of running the practice. And her employees have been there six years or longer. More than likely, she's going to treat her physician well if she treats the rest of the office staff well.
John: Absolutely. Well, let's see. We've seen in general over the last decade or two or longer, migration to more employment with large corporations, hospitals, health systems and so forth. Which brings me to the next question. The reason for that is it seems like they have more money sloshing around and they can buy your practice or they can recruit you even if things don't work out and they end up firing you in two years, they have you tied in.
So, what kind of things do you tell your clients, the physicians, in terms of what to expect when they're looking for a job like this? And are they going to have to take that into consideration that they might benefit on this side, but maybe the monetary will be later? How does that work?
Dr. Lara Hochman: Yeah. And before I even go into that, I'll say that different physicians are at a different point of being able to hear that, like truly hear that or be open to that. That conversation isn't really important to them. When it comes to hospital versus private practice, I would say probably the biggest one that affects people is salary. We forget that we are still in a business. The practices that we're working for still have to make money. The smaller practices are putting a lot of money into.
The physician owners actually don't take a salary while they pay you your salary versus the hospitals who are getting money from the imaging and the labs and the referrals and all the things that they do. And some of them are hiring people who will order more of those tests and make more money and that's where your salary is coming from. So, they are happy to lose money on the clinic visits themselves because they know they're going to make it up in all these other ways. I do hear from physicians, "I just want to be paid fairly" without a true understanding of what that actually means.
One of the downsides of private practice is that it's a smaller system and this could be a benefit, pro or a con being smaller, but one of the cons is that it doesn't have those large systems set up to be able to provide these giant salaries and amazing health insurance benefits and paid time off. But with that, that's what we call the golden handcuffs. So, you go work for these systems and you get used to be paying whatever salary it is that you're used to, and then you feel like you can't leave no matter how they treat you.
That's one of the most important things that I see, I see doctors who go work for hospitals and maybe have an idea going into it that they're not going to be so happy, or it's wonderful, but then administration changes and it's time for them to get out of it because they're just miserable.
The biggest thing is to really prepare for those circumstances. That means not signing a non-compete where you wouldn't be able to work in the city you live in if you were to leave them.
If there is a non-compete, there has to be a way to get out of it. If they fire you, maybe the non-compete is void or you can have what's called a sunrise or a sunset close on your non-compete where it's not valid after a certain number of years working there. There needs to be some sort of wiggle room so that when you sign that contract with the hospital, you have a way of leaving them. Because they know that they've got us, they have us. We are not leaving because they're giving us the salary, they're giving us the time off and the health insurance and all these things that are amazing. And if we leave, we have to leave town. They don't care about us. If they actually cared about their physicians as human beings and medicine in general, and patients, they wouldn't be doing these things. They'd be retaining us by treating us well rather than retaining us by not giving us a choice otherwise.
John: No, that's absolutely true. And it's a reason you need to have a good attorney look at these contracts because there's usually some wiggle room. But if you don't even ask, you're not going to get the concessions. It's a really good point.
The other thing that I've seen in the past when I was working as a CMO is we would try to put the onus for the malpractice sometimes, or at least part of it on the physician. If they left after a year or two, they were going to be subject to tail coverage or something like that, which I've come to believe that's just ridiculous because it's a cost of doing business. If they won't do that, you shouldn't even consider working with an institution like that because again, it's the worst of the handcuffs and it's not fair.
Given that though, you might have to go with a private partner and what have you. The income at first might not be as high as what's published by hospitals, but long term you're going to be a lot happier and have a lot more satisfaction. Let me pause here, by the way. Give us your website address right now so I don't forget. Some people don't listen all the way to the end. So, we're going to find Happy Day Health where?
Dr. Lara Hochman: It's happydayhealth.co. And you can find me on LinkedIn as well. It's Lara Hochman MD.
John: Okay. We'll put that in the show notes and we'll talk about that again at the end here. Have you gotten any feedback from people that you've placed with these practices? Have you heard back from how things are going three, six months in?
Dr. Lara Hochman: Yeah, they're doing great. They're so happy. One guy said I saved his life, and there are no words for that. They're just happy and they're like, "I didn't realize, I had no idea what I was missing" or "Thank you for opening my eyes up to." I had a DBC recently, "Thank you for opening my eyes to DBC." Even a physician who I didn't place has said, "Thank you so much. You've changed the way I practice. You've changed the way I look for practices." So, it's a lot of fun. It's very rewarding and doctors are just happier. Some of these were physicians who were considering leaving medicine entirely and they're really enjoying it.
John: Any general advice now? Because someone who's been in practice has been burned out, they know they're looking for something different. But let's say you're coming out of residency and you really don't know, and again, you're going to be pulled into that funnel, you're going to see all these ads. Other advice or just things that they should think about a little bit before necessarily ruling out one of these potentially lower-paying but more life-affirming positions?
Dr. Lara Hochman: Yeah. Oh, my gosh. I have so many things to say. When it comes to salary, the few things to know are to look at the starting salary and the potential earnings because it can actually potentially be much higher in private practice. You just have to be able to delay gratification a little bit longer. Also, especially for the new grads, I see very frequently where doctors want to interview at so many different places and then in the process, they may actually lose the perfect job where they know it's the one they want, but we're not used to making decisions and so we overanalyze it and take too much time and then can lose that.
I would say if you find a practice that you feel will treat you well and pay you a salary that you're happy with, do it. Don't wait. You don't want to lose out on something awesome because you were just kind of all over the place.
And I understand if you've never worked in a practice before as an attending, then how do you know what you're looking for? But as long as you protect yourself like we spoke about with a non-compete and all of those things, then you're good. But yeah, I would say pick the practice that will treat you the best because life is a journey. We're not racing to retirement. You want to enjoy every day.
John: Maybe if you're a resident or fellow and you're coming out and you've been in an academic situation or something, maybe you need to spend a little bit of time just talking to a couple of people who are in private practice as opposed to maybe everyone who's surrounded and they're in an academic practice or they're in a large hospital practice. Maybe talk to a few of those people that have been by themselves or in a small group or even a large group that's run by doctors. Maybe that'll give them a little insight into trying to make those decisions. Because you're right. It's easy to fall into that thing of just going with the higher salary and the upfront benefits, but later on you might regret it.
Dr. Lara Hochman: Yeah.
John: All right. Again, the website is happydayhealth.co. They can reach you, Dr. Lara Hochman on LinkedIn. I think this is really exciting. I hope you all the success. You need to keep us posted. Even if you want to do a little recruiting here, let me know. I'll put the word out if you're really having a hard time finding somebody because I'm sure some of my listeners are like, "Yeah, nice practice is just as good a way to solve burnout as becoming an MSL or something." Anyway, it's been my pleasure talking to you and I really appreciate you coming on the podcast today.
Dr. Lara Hochman: Yeah, thank you so much for having me.
John: Okay, you're welcome. Bye-bye.
Dr. Lara Hochman: Bye.
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