Interview with Dr. Lara Hochman – 363
In today's episode, Dr. Lara Hochman returns to the podcast to share her insights on finding joy when seeking a new practice.
Through Dr. Hochman's company, Happy Day Health, she matches physicians with private practices that prioritize their well-being and financial stability.
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Your Guide to a Stress-Free Medical Career
Dr. Lara Hochman introduces the Stress-Free Physician Career Guide, a free email course designed to help physicians navigate the job market with confidence. This resource covers essential topics such as vetting potential practices based on personal values, choosing the right employer, and negotiating salaries. By providing this guide, Lara aims to equip physicians with the knowledge they need to make informed career decisions and find positions that align with their aspirations and values.
Avoiding Common Pitfalls in Job Selection
One of the most common mistakes physicians make when choosing an employer is focusing solely on salary. Dr. Lara Hochman warns against this approach, advising physicians to consider factors like work-life balance, practice culture, and support systems. She emphasizes the importance of thoroughly vetting potential practices by speaking with current physicians and staff. By understanding what truly matters to them and asking the right questions, physicians can avoid pitfalls and find fulfilling positions that offer more than just a paycheck.
Dr. Lara Hochman's Advice on The Importance of Knowing What You Want
Knowing what you're looking for first, and then just going out and finding that… It's very cool to see when I work with physicians who know exactly what they want, and I find them that and they land the job and they're happy.
Summary
By thoroughly vetting practices and asking the right questions, physicians can find fulfilling positions that enhance their work-life balance and overall happiness. For more resources and information, visit Happy Day Health and connect with Dr. Hochman on LinkedIn or Instagram.
Links for Today's Episode:
- Dr. Lara Hochman's Website at Happy Day Health
- Dr. Lara Hochman's LinkedIn Page
- The Stress-Free Physicians Career Guide
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Transcription PNC Podcast Episode 363
Avoid These Mistakes When Seeking a New Practice
- Interview with Dr. Lara Hochman
John: As I've mentioned in previous episodes of the show, I'm becoming more and more convinced that we as physicians can find happiness in medical practice. I focus a lot on nonclinical careers, but I'm seeing more and more about practices that are really fun to be a part of. My guest today was here a couple of years ago, and she was talking about those situations because she matches physicians with practices. And so, I thought I'd have her come back to kind of complete that conversation. With that, I want to just say that I'm happy to have Dr. Lara Hochman here on the podcast again. Hi, Lara.
Dr. Lara Hochman: Hi, thank you so much for having me back. I'm so excited.
John: Well, good. You've been continuing to do what you were doing back then, in terms of connecting physicians with practices. I've talked to a lot of people, but I don't actually do the connecting and I never have a chance to really follow up with people necessarily if they've been on the podcast. I'm really looking for some of your advice and wisdom on this. But tell us a little bit about where things have gone, let's say in the last year and a half or two years since we spoke in terms of Happy Day Health and what you're doing, and remind our listeners as to what exactly we're talking about.
Dr. Lara Hochman: Sure. As the medical matchmaker, I created Happy Day Health as a company that really helps to match physicians with physician owned private practices. And these are practices that I have vetted, that I believe treat their physicians well, that are financially viable, and that are great places to work.
And I do this because I think it's important for us before deciding to make that leap into nonclinical medicine or to make that leap into all the dire things that we as physicians, look at what the other options are out there because there's some awesome places to work. And that's by having more physicians in private practice, this is how we really regain our voice as a physician community.
John: I agree a hundred percent. And so, I think it's going to be very useful for us to learn from you what we should really be looking at to optimize that situation. I have my ideas, but I'm not even going to get into that. And one of the things I noticed when I was looking at your website again, and reviewing some of your videos and that is that you created a new resource that I hadn't seen before called the Stress-Free Physician Career Guide. So why don't you tell us about that? Because I think our listeners, many will be interested in accessing that.
Dr. Lara Hochman: Yeah, this is an email course, it's completely free. And it runs through a little bit about vetting those practices for yourself. If you're looking for a job and trying to figure out what does that job even look like? Or how do you vet a practice according to your values? Because what's an ideal practice for me is not going to be the ideal practice for you. So using what you know about your values and what your dream job looks like, how do you use that to vet the practice and see if it's correct for you? And then how do you select your ideal employer? How do you negotiate your salary? So, it's just a very nice, easy, free resource for physicians to help answer a lot of the questions that I get repeatedly. And that are so important to know how to do.
John: Yeah, I talked to a lot of coaches by virtue of doing the podcast. And for many of them, the first step is always about identifying what your passion is, or what your goals are, or what your principles are, or vision, those kinds of things, you're starting a new business. And so it sounds like you start there, and then you just go even beyond that is to dig into exactly what you might be looking for.
One of the things that I used to advise people that were looking for a job in the hospital setting was the same thing was, make a list of everything you do, let's say in a day or a week, and separate them by what you love doing and what you hate doing, and then try and find a career that will optimize what you love and get rid of all of what you hate. So where do we find the career guide? I don't want to forget about sending people to the right place.
Dr. Lara Hochman: If you head to my website, which is www.happydayhealth.co, there's a tab at the top, the stress-free physician career guide, go ahead, and it'll be right there.
John: Just start filling it out and using it. Okay, cool. One of the ways I like to look at some things sometimes when people are thinking about their career, and it's kind of like clickbait when you look at the internet, but it's like mistakes to avoid. That's why I'm going to ask you questions about mistakes that we can avoid. So, let's start with, I'm assuming that you're dealing mostly with physicians who are coming from practice, maybe they're coming fresh out of residency or fellowship, but they're probably going to start as an employee. They may not end up that way, and I guess I'll ask you about that in a minute, but what's the biggest mistake when choosing an employer? Should we just go with the one that pays us the most? Or how do we find out for sure that we're going to like being at, working with some group, assuming mostly it's going to be a physician group?
Dr. Lara Hochman: That's funny, that would probably be the biggest mistake that I see is just going with the one that pays the most. And I totally get it. Yeah, it's not even desperate. It's the loans and I want to get paid my worth and I want to feel well compensated. And those are all very valid. But in doing that, there's a lot of other things that get overlooked a lot.
Maybe besides compensation, and I was speaking with a financial advisor once who said the best paying job is probably your red flag. That's the red flag is if it pays really well. You can think of it that way. But, yeah, it's definitely interesting how pay structure works. And especially in the insurance model and how insurance companies pay hospitals versus FQHCs versus private practice. That's all important to take into account.
But I would say the other biggest mistake, oh, gosh, it's so hard to narrow it down to one. One of the ones is interviewing too many places, which sounds silly, almost, but what I tend to see is that then you go into analysis paralysis, so you don't know what you're looking for beforehand. Then you're interviewing at multiple practices, you get multiple offers, they're all a little bit different from each other. What ends up happening is you just shut down. When you have too many tabs open in your brain, and these are big tabs. This is a big life decision. And then it often people just end up picking the highest paying one.
So, knowing what you're looking for first, and then just going out and finding that. It's very cool to see when I work with physicians who know exactly what they want, and I find them that and they land the job and they're happy, like, easy peasy versus the ones and typically those are the younger new grads or anything don't really know what they want yet. And they just look everywhere. And then sometimes they'll lose opportunities because they take too long. And that may have been this incredible opportunity that they've lost. So, that would be a big one. And one that I think would be pretty unexpected.
Another one is not vetting the practice appropriately. You hear a lot of times, even in physician owned practices of a bait and switch they promised me this, but then I got that. And it's actually pretty easy to avoid that situation just by speaking with physicians that are already in the practice saying, well, an example is a physician I recently placed in this pretty cool practice. She came from a bait and switch situation where she was a high producer. She wanted to see a lot of patients. She was promised a lot of patients and she was paid purely on production, which is great potentially, but turns out they couldn't even fill her schedule more than five patients a day. That's something that could have been avoided. So, not vetting the practice appropriately is really important. So you don't get into the bait and switch situation.
John: Yeah. I was chatting with a physician recently that I know very well and he's fresh out of residency a year or so ago. And he had that exact situation. It looked like a good practice. It was actually physician run and owned have been around a long time, but his volume was nowhere near what they said it would be. They practically guaranteed it, although not in the contract of course. And he wasn't making anywhere near because the productivity kicked in at the end of the first year and he was still in the process of building his practice. So that was rough for sure. And he's gone somewhere else now, which is very disruptive.
Dr. Lara Hochman: Yeah. It's so important to know what you're getting yourself into. And on the flip side, the practices that are hiring, it's expensive to hire doctors and you don't want to tell them the wrong thing and then have them arrive and realize it's something different and leave. Because then you've lost many tens of thousands of hundreds of thousands of dollars by hiring someone unnecessarily. So, practices need to be honest as well. It's really a two way street.
John: And I think we talked about this last time that maybe physicians don't have deep pockets. If they're a small group, three, five, 10, whatever, even a group of 20, they don't have the resources of a large hospital system. So focusing on the pay is probably, the cultures of those two situations are completely different. Again, it gets back to what you said before about focusing on the, just the pay.
Dr. Lara Hochman: Yeah. There's so much more to that. And especially with how much we want a good quality of life as we should, those are really important things to look at. What's your work-life balance going to be like, what what's the culture of the practice going to be like, will you have a voice? Will you have autonomy? Will admin listen to you? Do you have support? There's so many things that are going to be important to avoid burnout. That's really should not be overlooked. It's really important.
John: What about to switch gears a little bit, just in terms of negotiating everyone, maybe you find the ideal practice, looks like it would be ideal, but you do have to go through that process. So maybe mistakes you might see related to negotiating the contract once it gets to that point.
Dr. Lara Hochman: The big things are around transparency. I don't really see negotiating as I'm going to say what I want and you say what you want and it's buttheads until someone has to give in. Negotiating really is coming to an agreement on what works on both sides. And really working towards that together, I think is so important.
If you're just closed mind and you're like, I want X, Y, Z, and this is it, or else you're probably not going to get anywhere. You're not going to get what you want and versus using the example of tail malpractice insurance, I went tail, the practice doesn't want to provide tail. Well, maybe you can meet in the middle and see how it'll work for both. Obviously, tail is going to be less expensive for something like pediatrics than it would for OB-GYN or neurosurgery. But if I stay three years, perhaps you can pay 50%. If I stay, stay five years, you'll pay 100%, whatever it is, but trying to find something that works for both ends. Because if you're going to ask a new an OBGYN practice to pay your $100,000 tail, if you leave off to one year, that's probably not fair. Seeing it from both sides really is important, when it comes to negotiating for sure.
John: When I was CMO of a hospital, I used to do a lot of contract negotiations. And when I came away with, once I left was yeah, a small practice is not going to be able to put all that money out after one year of work and you just leave. But if you're working for a large hospital system, I put my foot down and say, look, this is the cost of doing business in that situation. But when it comes to, you got to give your physician partners a little bit of a break. If you're talking about tail for a very high cost specialty, that makes perfect sense. Anything else in the contracts that you've found maybe have been stumbling blocks that maybe unnecessarily prevented someone from accepting a relatively good or very good position?
Dr. Lara Hochman: Yeah, actually recently I had a physician, wonderful physician with an incredible practice who she had her dollar amount that she wanted to earn and just wasn't realistic. She didn't want to see a whole bunch of patients. So, unfortunately the math didn't work. But she was coming from a big hospital system that could blow money and was burnt out seeing 20 patients a day coming to a small private practice who had scribes admin support. When you're done, you're done. Awesome culture. This practice is just exemplary, really, really good practice, good morals, good ethics. But they see far more patients a day than this physician was used to.
And what it ended up coming down to was the practice said, we love this physician. We would love to have her join our team. However, she'd be seeing half the amount of patients we are and getting paid more. And we can't justify it. We can't that she's not even bringing in the revenue to be able to justify her salary.
I think knowing what it is that you're asking is so important. And that comes back down to the win-win situation that we were talking about earlier, but understanding what it is you're asking for before asking for it, and then truly actually listening to what the practice is saying back, because you may lose the job opportunity of your lifetime. And you may have been willing to take that lower salary, but because you didn't quite play ball, so to speak not take part in that two-way conversation, you may lose something that could be really cool.
John: Yeah, because every practice is totally different. And if one is very efficient, it has a lot of support like you said, they had scribes. That gets rid of a lot of work. Oh boy, that's probably based on just, again, she was fixated on one thing, and that was the most important, and she wasn't going to listen to any kind of alternatives.
Well, again, that gets back to the vetting. When I think about vetting like hospital systems, there's a lot of data out there publicly, probably not so much for physicians, but give us a few examples. Who should they talk to if they're trying to vet a practice? I can imagine there's be dozens of different approaches to trying to get information, including maybe talking to some of the patients, but what do most of your clients do to try and learn as much as they can about an opportunity?
Dr. Lara Hochman: The first step is in the interview. Really, there are almost no wrong questions. There's wrong ways to ask certain questions. But if there's something that you're afraid to ask, it probably means it's one of the most important things to ask. So, I'll have doctors who say this is really important to me, but I'm afraid to ask it. I really want to be a partner, but I don't want to scare them away, but if that's something that's really important to you, you definitely want to ask. It goes back to knowing your values and knowing what's important to you, and that's where that starts. Ask the hard questions. Definitely not just ask them, but ask them in a nice way. How would you want to be asked certain questions? Speak with other physicians that are already in the practice. If you're interviewing with a practice that only has one physician or one clinician, speak to the office manager. Speak to the medical assistants. Look at the turnover rate.
So, if the practice is turning over their office managers or billing people, that's potentially a red flag. So, look at that. If there's no one to speak to, well, that's not really very good. And then you want to ask those people about things that are important to you. You can ask around in the community. What I like to do when I'm interviewing for jobs or I actually went to a practice as a patient who now ended up being a repeat client of mine, but when I was in the waiting room, I was speaking with the receptionist and asking her what's it like working for this practice? She didn't know who I was. She didn't even know that I was evaluating if I wanted to work with them as help them find a doctor. But speaking with as many people as you can is one of the most important things. And if there are more than one physician in the practice, those are the people you want to speak to.
John: Okay. This is a question I think that my listeners will have. So, you've connected these physicians with practices. It's mostly physician run practices. Do the majority of those, are they looking for eventual partnership? Are some of them looking just to remain an employee, if it suits them? What's your experience been with that sort of goal?
Dr. Lara Hochman: It's about 50-50, I would say. The practices that are looking for partners, part of how I vet it is are they actually looking for a partner or are they just saying you're a partner so that they'll draw you in? Yeah, the practices that I work with that are looking for a partner are looking for a true partner. They want someone to bounce business ideas off of. They want someone to help them grow their practice. They want someone to be a part of the business, and typically they will start teaching you that before you become partners so that at the time of partnership, you can hit the ground running.
John: Okay. Another question that might come up, I'm thinking for my listeners. We've heard a lot about physicians going into practice that they love. And one of the options that some of the solo people have done that I've talked to have gone into a DPC. And I think I saw that one of your listings had specifically mentioned that. So, where does that fall in this? Are many of your practices that you're working with, are they DPCs? Are more going that way? What's your feedback on that whole situation?
Dr. Lara Hochman: There's definitely more DPCs opening up for sure. There's no question about that. As more people learn about it, it's such an attractive option. Some of my practices are direct primary care, direct specialty care or concierge. I wouldn't say the majority yet. I imagine that will change as more and more practices open, but it's an incredible option. It's really great.
John: Okay. All right. I'm trying to think of other questions that I've been asked personally, or that I have. Those are the top things that I was interested in learning about. And I mean, it sounds very hopeful to me. I think I'm going to have to get some more guests running DPCs and things like that. Tell us your website again, where can we find you and where can we look for the Stress-Free Physician Career Guide?
Dr. Lara Hochman: My website is www.happytohealth.co. Please check it out. That's where I have all of my jobs posted that I'm currently helping. You can sign up if there's something you don't see that you want, you can sign up and I'll let you know when something does come up for that. The Stress-Free Physician Career Guide is on there. There's a link to a course that I ran on opening your own practice. Anything is on there. I'm on social media, LinkedIn, Laura Hockman MD is where I'm the most active. I am on Instagram, Happy Day MD, I think. I don't even know.
John: I forget where my social media is. But yes, definitely. I saw the YouTube videos. So they're definitely going to be found there. You've been on another podcast, I'm sure, where you address this issue. So we can look for you there. All right. I guess I'm going to let you go in a minute here. But I'm just thinking, okay, if you're currently an employed physician, you're in a practice or working for a large corporation, you're probably doing the usual insurance company driven healthcare and you're getting miserable, any other advice you have just in general for how these people should think about the rest of their careers while they're feeling miserable?
Dr. Lara Hochman: Yeah, we got one life, we have to enjoy it. There'll be no job that's going to be good 100% of the time. But if you're miserable, why wait? What are you waiting for? If you're so unhappy, there's going to be something better, whether it's nonclinical, and that's where your podcast really can come in handy, or something clinical is out there that you enjoy, I would say, open up your mind. There's a lot of where we feel like we need to be practicing one way or we need to do it one way or another.
What have you got to lose? Take a job that sees less patients, take a job that if you want to stay clinical, think about what it is you actually don't like about your job. And most of what I hear is not clinical part, it's the admin part. So there's jobs available out there where you can still see patients and still do good in the world, and not have to deal with all the admin stuff. So you got this, it's just a matter of finding what you want, but knowing what you want first, so that you can go out and find it.
John: Yeah, so many physicians obviously want to be taking care of patients. And like you said earlier, there may be that practice not that far away that just has scribes, and you don't have to deal with the EMR as much as you do now, or whatever that issue might be. I think things are starting to turn for the better. I really appreciate you doing what you do and sharing these updates with us from time to time so that we keep the faith. Thanks again for being here today, Lara.
Dr. Lara Hochman: Yeah, thanks so much for having me. I really appreciate it.
John: You're welcome. I'll hopefully talk to you again next year or two.
Dr. Lara Hochman: Great.
John: Bye-bye.
Dr. Lara Hochman: Bye.
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Transcription PNC Podcast Episode 363
Avoid These Mistakes When Seeking a New Practice
- Interview with Dr. Lara Hochman
John: As I've mentioned in previous episodes of the show, I'm becoming more and more convinced that we as physicians can find happiness in medical practice. I focus a lot on nonclinical careers, but I'm seeing more and more about practices that are really fun to be a part of. My guest today was here a couple of years ago, and she was talking about those situations because she matches physicians with practices. And so, I thought I'd have her come back to kind of complete that conversation. With that, I want to just say that I'm happy to have Dr. Lara Hochman here on the podcast again. Hi, Lara.
Dr. Lara Hochman: Hi, thank you so much for having me back. I'm so excited.
John: Well, good. You've been continuing to do what you were doing back then, in terms of connecting physicians with practices. I've talked to a lot of people, but I don't actually do the connecting and I never have a chance to really follow up with people necessarily if they've been on the podcast. I'm really looking for some of your advice and wisdom on this. But tell us a little bit about where things have gone, let's say in the last year and a half or two years since we spoke in terms of Happy Day Health and what you're doing, and remind our listeners as to what exactly we're talking about.
Dr. Lara Hochman: Sure. As the medical matchmaker, I created Happy Day Health as a company that really helps to match physicians with physician owned private practices. And these are practices that I have vetted, that I believe treat their physicians well, that are financially viable, and that are great places to work.
And I do this because I think it's important for us before deciding to make that leap into nonclinical medicine or to make that leap into all the dire things that we as physicians, look at what the other options are out there because there's some awesome places to work. And that's by having more physicians in private practice, this is how we really regain our voice as a physician community.
John: I agree a hundred percent. And so, I think it's going to be very useful for us to learn from you what we should really be looking at to optimize that situation. I have my ideas, but I'm not even going to get into that. And one of the things I noticed when I was looking at your website again, and reviewing some of your videos and that is that you created a new resource that I hadn't seen before called the Stress-Free Physician Career Guide. So why don't you tell us about that? Because I think our listeners, many will be interested in accessing that.
Dr. Lara Hochman: Yeah, this is an email course, it's completely free. And it runs through a little bit about vetting those practices for yourself. If you're looking for a job and trying to figure out what does that job even look like? Or how do you vet a practice according to your values? Because what's an ideal practice for me is not going to be the ideal practice for you. So using what you know about your values and what your dream job looks like, how do you use that to vet the practice and see if it's correct for you? And then how do you select your ideal employer? How do you negotiate your salary? So, it's just a very nice, easy, free resource for physicians to help answer a lot of the questions that I get repeatedly. And that are so important to know how to do.
John: Yeah, I talked to a lot of coaches by virtue of doing the podcast. And for many of them, the first step is always about identifying what your passion is, or what your goals are, or what your principles are, or vision, those kinds of things, you're starting a new business. And so it sounds like you start there, and then you just go even beyond that is to dig into exactly what you might be looking for.
One of the things that I used to advise people that were looking for a job in the hospital setting was the same thing was, make a list of everything you do, let's say in a day or a week, and separate them by what you love doing and what you hate doing, and then try and find a career that will optimize what you love and get rid of all of what you hate. So where do we find the career guide? I don't want to forget about sending people to the right place.
Dr. Lara Hochman: If you head to my website, which is www.happydayhealth.co, there's a tab at the top, the stress-free physician career guide, go ahead, and it'll be right there.
John: Just start filling it out and using it. Okay, cool. One of the ways I like to look at some things sometimes when people are thinking about their career, and it's kind of like clickbait when you look at the internet, but it's like mistakes to avoid. That's why I'm going to ask you questions about mistakes that we can avoid. So, let's start with, I'm assuming that you're dealing mostly with physicians who are coming from practice, maybe they're coming fresh out of residency or fellowship, but they're probably going to start as an employee. They may not end up that way, and I guess I'll ask you about that in a minute, but what's the biggest mistake when choosing an employer? Should we just go with the one that pays us the most? Or how do we find out for sure that we're going to like being at, working with some group, assuming mostly it's going to be a physician group?
Dr. Lara Hochman: That's funny, that would probably be the biggest mistake that I see is just going with the one that pays the most. And I totally get it. Yeah, it's not even desperate. It's the loans and I want to get paid my worth and I want to feel well compensated. And those are all very valid. But in doing that, there's a lot of other things that get overlooked a lot.
Maybe besides compensation, and I was speaking with a financial advisor once who said the best paying job is probably your red flag. That's the red flag is if it pays really well. You can think of it that way. But, yeah, it's definitely interesting how pay structure works. And especially in the insurance model and how insurance companies pay hospitals versus FQHCs versus private practice. That's all important to take into account.
But I would say the other biggest mistake, oh, gosh, it's so hard to narrow it down to one. One of the ones is interviewing too many places, which sounds silly, almost, but what I tend to see is that then you go into analysis paralysis, so you don't know what you're looking for beforehand. Then you're interviewing at multiple practices, you get multiple offers, they're all a little bit different from each other. What ends up happening is you just shut down. When you have too many tabs open in your brain, and these are big tabs. This is a big life decision. And then it often people just end up picking the highest paying one.
So, knowing what you're looking for first, and then just going out and finding that. It's very cool to see when I work with physicians who know exactly what they want, and I find them that and they land the job and they're happy, like, easy peasy versus the ones and typically those are the younger new grads or anything don't really know what they want yet. And they just look everywhere. And then sometimes they'll lose opportunities because they take too long. And that may have been this incredible opportunity that they've lost. So, that would be a big one. And one that I think would be pretty unexpected.
Another one is not vetting the practice appropriately. You hear a lot of times, even in physician owned practices of a bait and switch they promised me this, but then I got that. And it's actually pretty easy to avoid that situation just by speaking with physicians that are already in the practice saying, well, an example is a physician I recently placed in this pretty cool practice. She came from a bait and switch situation where she was a high producer. She wanted to see a lot of patients. She was promised a lot of patients and she was paid purely on production, which is great potentially, but turns out they couldn't even fill her schedule more than five patients a day. That's something that could have been avoided. So, not vetting the practice appropriately is really important. So you don't get into the bait and switch situation.
John: Yeah. I was chatting with a physician recently that I know very well and he's fresh out of residency a year or so ago. And he had that exact situation. It looked like a good practice. It was actually physician run and owned have been around a long time, but his volume was nowhere near what they said it would be. They practically guaranteed it, although not in the contract of course. And he wasn't making anywhere near because the productivity kicked in at the end of the first year and he was still in the process of building his practice. So that was rough for sure. And he's gone somewhere else now, which is very disruptive.
Dr. Lara Hochman: Yeah. It's so important to know what you're getting yourself into. And on the flip side, the practices that are hiring, it's expensive to hire doctors and you don't want to tell them the wrong thing and then have them arrive and realize it's something different and leave. Because then you've lost many tens of thousands of hundreds of thousands of dollars by hiring someone unnecessarily. So, practices need to be honest as well. It's really a two way street.
John: And I think we talked about this last time that maybe physicians don't have deep pockets. If they're a small group, three, five, 10, whatever, even a group of 20, they don't have the resources of a large hospital system. So focusing on the pay is probably, the cultures of those two situations are completely different. Again, it gets back to what you said before about focusing on the, just the pay.
Dr. Lara Hochman: Yeah. There's so much more to that. And especially with how much we want a good quality of life as we should, those are really important things to look at. What's your work-life balance going to be like, what what's the culture of the practice going to be like, will you have a voice? Will you have autonomy? Will admin listen to you? Do you have support? There's so many things that are going to be important to avoid burnout. That's really should not be overlooked. It's really important.
John: What about to switch gears a little bit, just in terms of negotiating everyone, maybe you find the ideal practice, looks like it would be ideal, but you do have to go through that process. So maybe mistakes you might see related to negotiating the contract once it gets to that point.
Dr. Lara Hochman: The big things are around transparency. I don't really see negotiating as I'm going to say what I want and you say what you want and it's buttheads until someone has to give in. Negotiating really is coming to an agreement on what works on both sides. And really working towards that together, I think is so important.
If you're just closed mind and you're like, I want X, Y, Z, and this is it, or else you're probably not going to get anywhere. You're not going to get what you want and versus using the example of tail malpractice insurance, I went tail, the practice doesn't want to provide tail. Well, maybe you can meet in the middle and see how it'll work for both. Obviously, tail is going to be less expensive for something like pediatrics than it would for OB-GYN or neurosurgery. But if I stay three years, perhaps you can pay 50%. If I stay, stay five years, you'll pay 100%, whatever it is, but trying to find something that works for both ends. Because if you're going to ask a new an OBGYN practice to pay your $100,000 tail, if you leave off to one year, that's probably not fair. Seeing it from both sides really is important, when it comes to negotiating for sure.
John: When I was CMO of a hospital, I used to do a lot of contract negotiations. And when I came away with, once I left was yeah, a small practice is not going to be able to put all that money out after one year of work and you just leave. But if you're working for a large hospital system, I put my foot down and say, look, this is the cost of doing business in that situation. But when it comes to, you got to give your physician partners a little bit of a break. If you're talking about tail for a very high cost specialty, that makes perfect sense. Anything else in the contracts that you've found maybe have been stumbling blocks that maybe unnecessarily prevented someone from accepting a relatively good or very good position?
Dr. Lara Hochman: Yeah, actually recently I had a physician, wonderful physician with an incredible practice who she had her dollar amount that she wanted to earn and just wasn't realistic. She didn't want to see a whole bunch of patients. So, unfortunately the math didn't work. But she was coming from a big hospital system that could blow money and was burnt out seeing 20 patients a day coming to a small private practice who had scribes admin support. When you're done, you're done. Awesome culture. This practice is just exemplary, really, really good practice, good morals, good ethics. But they see far more patients a day than this physician was used to.
And what it ended up coming down to was the practice said, we love this physician. We would love to have her join our team. However, she'd be seeing half the amount of patients we are and getting paid more. And we can't justify it. We can't that she's not even bringing in the revenue to be able to justify her salary.
I think knowing what it is that you're asking is so important. And that comes back down to the win-win situation that we were talking about earlier, but understanding what it is you're asking for before asking for it, and then truly actually listening to what the practice is saying back, because you may lose the job opportunity of your lifetime. And you may have been willing to take that lower salary, but because you didn't quite play ball, so to speak not take part in that two-way conversation, you may lose something that could be really cool.
John: Yeah, because every practice is totally different. And if one is very efficient, it has a lot of support like you said, they had scribes. That gets rid of a lot of work. Oh boy, that's probably based on just, again, she was fixated on one thing, and that was the most important, and she wasn't going to listen to any kind of alternatives.
Well, again, that gets back to the vetting. When I think about vetting like hospital systems, there's a lot of data out there publicly, probably not so much for physicians, but give us a few examples. Who should they talk to if they're trying to vet a practice? I can imagine there's be dozens of different approaches to trying to get information, including maybe talking to some of the patients, but what do most of your clients do to try and learn as much as they can about an opportunity?
Dr. Lara Hochman: The first step is in the interview. Really, there are almost no wrong questions. There's wrong ways to ask certain questions. But if there's something that you're afraid to ask, it probably means it's one of the most important things to ask. So, I'll have doctors who say this is really important to me, but I'm afraid to ask it. I really want to be a partner, but I don't want to scare them away, but if that's something that's really important to you, you definitely want to ask. It goes back to knowing your values and knowing what's important to you, and that's where that starts. Ask the hard questions. Definitely not just ask them, but ask them in a nice way. How would you want to be asked certain questions? Speak with other physicians that are already in the practice. If you're interviewing with a practice that only has one physician or one clinician, speak to the office manager. Speak to the medical assistants. Look at the turnover rate.
So, if the practice is turning over their office managers or billing people, that's potentially a red flag. So, look at that. If there's no one to speak to, well, that's not really very good. And then you want to ask those people about things that are important to you. You can ask around in the community. What I like to do when I'm interviewing for jobs or I actually went to a practice as a patient who now ended up being a repeat client of mine, but when I was in the waiting room, I was speaking with the receptionist and asking her what's it like working for this practice? She didn't know who I was. She didn't even know that I was evaluating if I wanted to work with them as help them find a doctor. But speaking with as many people as you can is one of the most important things. And if there are more than one physician in the practice, those are the people you want to speak to.
John: Okay. This is a question I think that my listeners will have. So, you've connected these physicians with practices. It's mostly physician run practices. Do the majority of those, are they looking for eventual partnership? Are some of them looking just to remain an employee, if it suits them? What's your experience been with that sort of goal?
Dr. Lara Hochman: It's about 50-50, I would say. The practices that are looking for partners, part of how I vet it is are they actually looking for a partner or are they just saying you're a partner so that they'll draw you in? Yeah, the practices that I work with that are looking for a partner are looking for a true partner. They want someone to bounce business ideas off of. They want someone to help them grow their practice. They want someone to be a part of the business, and typically they will start teaching you that before you become partners so that at the time of partnership, you can hit the ground running.
John: Okay. Another question that might come up, I'm thinking for my listeners. We've heard a lot about physicians going into practice that they love. And one of the options that some of the solo people have done that I've talked to have gone into a DPC. And I think I saw that one of your listings had specifically mentioned that. So, where does that fall in this? Are many of your practices that you're working with, are they DPCs? Are more going that way? What's your feedback on that whole situation?
Dr. Lara Hochman: There's definitely more DPCs opening up for sure. There's no question about that. As more people learn about it, it's such an attractive option. Some of my practices are direct primary care, direct specialty care or concierge. I wouldn't say the majority yet. I imagine that will change as more and more practices open, but it's an incredible option. It's really great.
John: Okay. All right. I'm trying to think of other questions that I've been asked personally, or that I have. Those are the top things that I was interested in learning about. And I mean, it sounds very hopeful to me. I think I'm going to have to get some more guests running DPCs and things like that. Tell us your website again, where can we find you and where can we look for the Stress-Free Physician Career Guide?
Dr. Lara Hochman: My website is www.happytohealth.co. Please check it out. That's where I have all of my jobs posted that I'm currently helping. You can sign up if there's something you don't see that you want, you can sign up and I'll let you know when something does come up for that. The Stress-Free Physician Career Guide is on there. There's a link to a course that I ran on opening your own practice. Anything is on there. I'm on social media, LinkedIn, Laura Hockman MD is where I'm the most active. I am on Instagram, Happy Day MD, I think. I don't even know.
John: I forget where my social media is. But yes, definitely. I saw the YouTube videos. So they're definitely going to be found there. You've been on another podcast, I'm sure, where you address this issue. So we can look for you there. All right. I guess I'm going to let you go in a minute here. But I'm just thinking, okay, if you're currently an employed physician, you're in a practice or working for a large corporation, you're probably doing the usual insurance company driven healthcare and you're getting miserable, any other advice you have just in general for how these people should think about the rest of their careers while they're feeling miserable?
Dr. Lara Hochman: Yeah, we got one life, we have to enjoy it. There'll be no job that's going to be good 100% of the time. But if you're miserable, why wait? What are you waiting for? If you're so unhappy, there's going to be something better, whether it's nonclinical, and that's where your podcast really can come in handy, or something clinical is out there that you enjoy, I would say, open up your mind. There's a lot of where we feel like we need to be practicing one way or we need to do it one way or another.
What have you got to lose? Take a job that sees less patients, take a job that if you want to stay clinical, think about what it is you actually don't like about your job. And most of what I hear is not clinical part, it's the admin part. So there's jobs available out there where you can still see patients and still do good in the world, and not have to deal with all the admin stuff. So you got this, it's just a matter of finding what you want, but knowing what you want first, so that you can go out and find it.
John: Yeah, so many physicians obviously want to be taking care of patients. And like you said earlier, there may be that practice not that far away that just has scribes, and you don't have to deal with the EMR as much as you do now, or whatever that issue might be. I think things are starting to turn for the better. I really appreciate you doing what you do and sharing these updates with us from time to time so that we keep the faith. Thanks again for being here today, Lara.
Dr. Lara Hochman: Yeah, thanks so much for having me. I really appreciate it.
John: You're welcome. I'll hopefully talk to you again next year or two.
Dr. Lara Hochman: Great.
John: Bye-bye.
Dr. Lara Hochman: Bye.
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