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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Today's PNC Podcast Transcript

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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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Disclaimers:

Many of the links that I refer you to, and that you’ll find in the show notes, are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you, that I have personally used or am very familiar with.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

The post Avoid These Mistakes When Seeking a New Practice appeared first on NonClinical Physicians.

How to Start Your Own Medical Writing Business: A Practical Guide

Starting your own medical writing business can be both exciting and challenging. Whether you're an experienced medical writer or a healthcare professional looking to transition into writing, setting up your business involves several important steps. Here’s a straightforward guide to help you get started.

1. Identify Your Niche
   First, define the kind of medical writing you want to specialize in. The field includes technical writing for pharmaceutical companies, journalistic writing for physicians and patients, and writing continuing medical education (CME) manuscripts. Knowing your niche will help you target clients and tailor your marketing efforts.
2. Create a Business Plan
   A business plan is your roadmap to success. Outline your goals, target audience, pricing strategy, and marketing plan. Here’s what to include:
   • Mission Statement: Define why the organization exists, what its overall goal is, the kind of product or service it provides, and its primary customers or market.
   • Market Analysis: Research your target market and competitors.
   • Services Offered: List the types of writing you plan to provide.
   • Pricing Strategy: Set your rates based on industry standards and your experience.
   • Marketing Plan: Plan how you will reach potential clients, including creating a website, leveraging social media, and networking.
3. Choose Your Business Structure
   Decide on the legal structure for your business—sole proprietorship, LLC, or corporation. Each has its own legal and tax implications. It might be worth consulting a business attorney or accountant. Also, don't forget to register your business name and get any necessary licenses or permits.
4. Build an Online Presence
   In today's world, having a professional online presence is crucial. Create a website that showcases your services, portfolio, and contact information. Consider including:
   • About: Share your background and qualifications.
   • Services: Detail the writing services you offer.
   • Portfolio: Provide samples of your work.
   • Testimonials: Include feedback from past clients.
   • Blog: Post industry insights and writing tips to demonstrate your expertise.
5. Network and Market Yourself
   Networking is key in the medical writing industry. Join professional organizations like the American Medical Writers Association (AMWA) or the International Society for Medical Publication Professionals (ISMPP). Attend conferences, webinars, and workshops to connect with potential clients and stay updated on industry trends. Use social media, especially LinkedIn, to build your professional network and highlight your expertise.
6. Get Your First Clients
   Getting your first clients can be tough but rewarding. Start by reaching out to your existing network and offering your services. You might consider doing some work for free or at a discount to build your portfolio and get testimonials. Freelance platforms like Upwork, Freelancer, and specialized medical writing job boards can also help you find opportunities.
7. Manage Your Business Operations
   Effective business management is crucial for long-term success. Set up systems for tracking income and expenses, invoicing clients, and managing deadlines. Tools like QuickBooks for accounting and Trello or Asana for project management can help keep you organized.

More on using LinkedIn

Many publishing, continuing education, and medical communication companies look to LinkedIn to find prospective new writers. It is an excellent platform to showcase your work and list the companies for which you've written. And by publishing your work on the site, you can attract followers who might refer or hire you.

Summary

Starting a medical writing business requires careful planning, networking, and dedication. By following these steps, you can build a successful business that leverages your expertise and meets your clients' needs. Stay adaptable and continuously look for opportunities to grow and develop professionally.

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Why Build Your Own Rewarding CME and CE Writing Business?
• How To Know If You Will Love Medical Writing
• How to Shine as a Technical Medical Writer – 155
• Why Medical Communications Is the Best Nonclinical Career – 061
• Dr. Debra Blaine's Coaching Services

Disclaimers:

Some of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. I only promote products and services that I believe are of high quality and will be useful to you. As an Amazon Associate, I earn from qualifying purchases.

The opinions expressed here are mine alone. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

The post How to Set Up Your Medical Writing Business appeared first on NonClinical Physicians.

Interview with Ethan Nkana – Episode 339

In today's episode, Ethan Nkana explains how to negotiate a great contract, avoid burnout, and protect yourself legally.

Ethan's advice revolves around empowering physicians to advocate for their best interests, understand the nuances of their contracts, and seek professional assistance for optimal negotiations.

Our Show Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Did you know that you can sponsor the Physician Nonclinical Careers Podcast? As a sponsor, you will reach thousands of physicians with each episode to sell your products and services or to build your following. For a modest fee, your message will be heard on the podcast and will continue to reach new listeners for years after it is released.  The message will also appear on the website with over 8,000 monthly visits and in our email newsletter and social media posts. To learn more, contact us at john.jurica.md@gmail.com and include SPONSOR in the Subject Line.

Our Episode Sponsor

Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

A Crucial Step in Career Success

In this interview, Ethan Nkana, founder of the Rocky Mountain Physician Agency (RMPA), sheds light on the often-overlooked importance of negotiating your best employment contract. The conversation highlights the significant role contract negotiations play in a physician's career course. These negotiations have an enormous impact on overall job satisfaction, financial well-being, and work-life balance. Ethan's expertise, honed through years of working in hospitals, is presented as a valuable resource for physicians navigating this complex terrain.

Key Considerations in Physician Contract Negotiations

Ethan provides practical insights into the essential elements of physician contracts, guiding both new and experienced physicians. From compensation and restrictive covenants to job duties and support resources, the discussion offers a roadmap for physician employment agreements.

On this matter, we explore the top two or three critical elements that physicians should prioritize. These topics are demystified, with Ethan offering his valuable insights. Tail coverage for malpractice insurance and considerations for experienced physicians seeking contract renegotiation are also explored.

Ethan Nkana's Advice for New Graduates

It's a matter of asking, knowing how to ask, and what to ask for. For the first time attendings coming out, please do not feel as though you have to sign whatever is put in front of you… I want to encourage you, please advocate for yourselves, know what matters to you most, and ask for those things in your contract. 

Summary

Ethan shared valuable insights into why you must fight for your best employment contract, and what to prioritize. He also reminds us that there are professionals like him who will serve as your agent to get you the best contract possible.

NOTE: Look below for a transcript of today's episode. 

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Rocky Mountain Physician Agency
• Ethan Nkana's LinkedIn Profile
• Ethan Nkana's Phone Number: 720-471-0059
• More on Understanding Relative Value Units (RVUs) in Employment Agreements
• Physician Employment Agreements
• Get Ready for What Will Happen When You Quit Your Miserable Job – 213
• Root Causes of Physician Burnout – Interview with Dr. Dike Drummond – 028
• Dr. Debra Blaine's Coaching Services

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 339

Negotiate a Great Contract, Avoid Burnout, and Be Happy

- Interview with Ethan Nkana

John: Sometimes physicians can be their own worst enemies. We finish our training and agree to work for a large practice or a hospital system, and then two or three years later we're miserable. And we discover that our contract does not protect us from being mistreated or underpaid. My guest today is Ethan Nkana, and he's here today to help us avoid those issues. Welcome Ethan. I'm glad to have you here today.

Ethan Nkana: Thank you so much for having me, John. It is a delight to be here with you.

John: I don't know why I haven't talked to someone like you sooner. I've been doing this podcast for several years and I've always focused on nonclinical, but the reality is, for most physicians, they want to go clinical. And they may not want to do it forever, but heck, if they're going to work clinically, they shouldn't be subject to low salaries and being beat up and burned out after two years. I think some of what you're going to tell us today is going to help us avoid that. And I really do think, and I don't talk about this enough, but every physician that's going to be employed really has to have someone help them negotiate their contract. That's my opening for you. Take it from there. Tell us about your background and how you got into this.

Ethan Nkana: Yeah, spot on, John. And actually I want to touch on what you said a moment ago. So much of what I get to do in my job is education. And so, I think it's so important for doctors first to understand what is in your contract and the risks, the benefits and burdens, all of those things. During our conversation I don't want this to sound like a sales pitch for my business. I want to help doctors know how to do it for themselves so they don't need someone like me.

But I think you highlighted something that is extremely important about the relationship that doctors have with employers is often overestimated. And so, doctors have this fierce loyalty to employers, which they find out the hard way is not necessarily reciprocated. I'm glad that you and I get to talk today.

John: I'm going to say another prelude to this whole conversation for those that are listening, because I used to do negotiations on the hospital side for these physicians. I think when you're negotiating or you're having someone negotiate for you, you have to realize, the way you set this thing up and the document that you sign is going to be what you're going to live by for the next few years. And if it turns out there's big holes in it or there's things in there that just don't align with what you thought you were getting, you're going to be miserable. Again, that's just my admonition to those as we get going. Tell us how you got started and I did a little intro separate from this and I talked about how you go back to the legacy with your mom, but tell us about that and then how you got into this.

Ethan Nkana: Absolutely, and I think one of the cool things about what I get to do now is it's kind of the only thing I've ever done in my career. As you mentioned, my mom is an anesthesiologist. Coming out of college, she told me, you've got to get into healthcare, you're going to always have a job. What she didn't know is that I got laid off in 2019 and all of a sudden kind of found myself having this existential crisis.

And in the midst of that crisis, I had this question, "Why don't doctors have agents like professional athletes?" I started thinking about your training journeys as a physician, how that parallels with an athlete. Then you go pro and there's all of this money and athletes hire agents, but doctors tend to DIY it. And so, I founded RMPA - Rocky Mountain Physician Agency as an agency for physicians. And so, my job is similar to a talent agent, athletes, actors, you name it, my job is to negotiate and renegotiate physician contracts for the most money and best terms for my doctors.

John: Now that leads me to a question about that process. Do you usually get involved with their first contract or do you have a lot that are halfway through and now they're getting ready to re-up or renegotiate? Because I could figure that would be a whole different scenario.

Ethan Nkana: Yeah, we do actually quite a bit of both. We do first time attending, what we call rookie deals. Doctors who are coming out of residency and training. And we also negotiate deals for experienced doctors. As you mentioned, those are very different. The reason that for me, it's kind of like a fish in water is because the only thing I've done in my career is work in hospitals. From HR intern, which is my first job, supply chain, food and beverage, physician contracting, finance. If it's in a hospital, I've either done it or I know it.

And so, for me, it's really easy to kind of transition between, "Okay, I have a rookie doc who's going in their first contract. What are some of the things we want to prioritize?" But the cool thing about that though, John, is I get to see into the crystal ball of what attending doctors are concerned about. Then I get to say, "Hey, Dr. Jones, you might want to make sure that you lock in your call schedule, because that's the most common thing that experienced doctors call me about." It's kind of this cool dichotomy of getting to see doctors at the beginning of their career when it's all in front of you, and then I also get to work with doctors as they progress through their career, renegotiating their employment contracts.

John: And I think it's implied, but I have to ask you directly. Given your experience, even prior to doing this and then starting the agency and now doing this, would you agree that if you really pay attention and you get the right contract, life is going to go a whole lot better? Or on the other hand, maybe you walk away from something. If you can't get to that contract, it means there's something wrong. Is that your experience?

Ethan Nkana: That is spot on, John. I think that often gets overlooked because psychologically we are so averse to change. And so, when doctors think about what it takes in order for them to advocate for their best interest, there's this big barrier, this big wall of change that they have to go through, or they have to think about scaling. And so, a big part of my job is the psychological part of helping doctors understand, "Yes, there's going to be change and it's going to be worth it." You're going to be happier, you're going to have less stress, you're going to have more support in your practice, you're going to be more fulfilled with your work, and then obviously make a bunch more money to do that.

John: Awesome. All right, obviously you're not going to be able to walk through like a typical 15 page contract or something and cover all, but all the bases. But tell us in your experience what are the top two or three issues and what are some of the pitfalls and maybe the things where you really have to step in and say, "This isn't worded right, or we really have to pay attention to this?" Just take it away and we'll learn as much as we can from you.

Ethan Nkana: Yeah, great question. I have what I call the big five, which are the five provisions that if I had 15 minutes, here's where my eyes would go. First and foremost, the compensation. We're all looking for that big sexy six figure number to see what's my annual salary. But don't forget about your bonuses. Your production bonuses, volume bonuses, signing bonus.

The second thing that I'm looking at is education loan debt assistance. I can count on one hand how many doctors I've talked to who do not come out of training with some type of debt, usually in the six figure range. And so, my responsibility is also to help make sure doctors can pay that down as quick as possible. Going back to what you mentioned a moment ago, which you teed up is doctors being happier. And one way doctors are happier is when they have less student loan debt hanging over their head and then they can use that money to fund the lifestyle they've worked so hard for. And so, I always will encourage doctors to ask for education loan debt assistance. Those can be big dollars anywhere from $25,000 to $50,000, and sometimes above that a year in addition to whatever you're putting into that.

The third is non-competes. You've probably heard of those. They're also called restrictive covenants. The primary difference in this between sports and doctors is that in sports, once your contract ends, you can go play for any team who's going to hire you. But for doctors, it's so much more restrictive. And I don't think people appreciate that. When a doctor finishes their contract, that's when the restriction ends. Let's say you do five years with an employer and then they say, "Nope, you got to get out of town because you can't practice within 20 miles." So, who's going to move 20 miles away and they can change your school district for your kids and your church and social network? I don't have to go into all that, but the non-compete can be really burdensome.

I'll give you a quick cheat code. The non-compete penalty should be paid by your new employer. I often hear doctors say, "Well, I can't go anywhere because of my non-compete." Don't worry about that, negotiate that into your new contract so that way you don't have to worry about that. They'll give it to you upfront as a bonus. They're going to forgive it over the period of your contract. And that way if your employer comes knocking on your door saying, "Hey, you owe us X thousands of dollars", cool, I have a check for my new employer to pay you. So you don't have to worry about getting sued.

The other thing I want to look at is your job duties and schedule. This is huge. This is the thing I often say if doctors got the resources and support they needed from employers, I would be out of a job. But the fact of the matter is, medicine is a business and doctors are a very important cog in a very large wheel. And so, understanding what your clinical contact hours, your patient contact hours are each week, what are your call expectations. And then I just had this issue last week, what happens to call when a doctor leaves? Do they have a support pool to cover that for you? Or do other remaining doctors have to take more call and now impinge upon your lifestyle?

And then lastly, it's your resources and support. You want to make sure you have adequate administrative, clinical, financial support in your contract so that way you can perform at the highest level. It's stressful enough the work that doctors do. Make sure that the hospital provides you with the resources to play at the highest level or to care for patients at the highest level.

John: Those cover a lot of areas. Let me ask you a question or two, maybe about two or three of those. The salary. What drives it? Is it surveys? Is it, "Look, I'm just going to get as high salary as I can. If they're really hurting, then they're going to pay a lot of money." What do you find works the best? And do you usually find that you can get more dollars than the physician actually anticipated?

Ethan Nkana: Absolutely. Every time we go into negotiation, we make our doctors more money. I was asked by a physician group last week, "Well, what happens when that doesn't happen?" The way I get paid is a percentage of my doctor's pay. So, if I don't make them more money, I don't get paid. Our batting average has to be a thousand in order for us to even stay alive. So, we always make our doctors more money.

I think the important thing for doctors to understand, I'm going to bookend this. The most important things that I think would be how busy you are as a physician. Let's take your specialty out. Your specialty is going to of course drive. Like a neurosurgeon, generally speaking, is never going to make less than a nephrologist. That's just never going to happen realistically. We'll leave that out of the conversation. Let's just talk about within your specialty how salaries might change a little bit.

The doctors who generally make the most money are going to be the busiest doctors. My job when I worked in hospitals was to quantify for my CEO how much money we're going to make off of Dr. Jurica based on how busy you are, the type of procedures you do, and then the other counterbalancing expenses, how much do you cost us as a hospital? And then the balance between that is what's called the ROI or return on investment. Doctors are seen literally as line items on financial statements, and I could quantify down to the dollar how valuable doctors were to our hospital. And so, that rule sets the bar as like the busiest doctors generally tend to make the most money.

The other major consideration is where you're practicing. Even if you're looking at two high cost areas, say New York and California, you cannot compare those. Because there's just so many nuances. Now, I'm not an expert in finance, but there's just so much nuance. You must look in similar geographic regions, but then even within that, the care setting you're in matters. Some doctors are in private practice, some doctors in academics, some are in safety nets, like county hospitals.

The general rule of thumb that the data shows is that the fewer layers between the insurance carrier and the patient, the higher pay for the doctor. Private practice, highest pay. Insurance pays the doctor, who pays the practice, and then the expenses get paid for the practice from there. Then as you get to the world that I was in, which is, and I only worked in nonprofit, so I never worked for a for-profit hospital. But those hospitals are looking at "Well, how can we bring on the most doctors of a particular specialty within a geographic area?" They call them service areas.

And so, the chess game that I get to play is how can I help shift doctors among health systems in a way that they have to pay doctors the most money to either acquire or retain them. And so, my job is to help doctors maximize the value of that compensation with your employer. We're looking at "I'm going to pull your stats. I'm going to pull how busy you are." In sports, how many touchdowns did you throw? How many points did you score? How many rebounds did you grab? I want to know how many procedures did you do? How busy are you? Because those are the things that are going to impact your compensation. I can tell you from experience if you come in with the latest and greatest MGMA report, your hospital or employer will find 18 different ways to invalidate that data. "Well, this is looking at private practice. This is looking at left-handed doctors." Just save yourself the time, save yourself the money.

You should get a ballpark of what your salary should be. Doximity, Medscape, Merritt Hawkins, Physician Thrive. They all publish national and annual surveys on physician compensation. So you should have a ballpark of what you should be making. But if you think that that's going to help you in negotiation, you're just going to get laughed out of the room, unfortunately.

John: Now, one of the things that I remember that really drove physicians crazy in this process is the actual way that they're paid. And I'm sure it's changed since I was involved with this, which is more than 10 years ago. Well, they are going to be paid based on RVUs, number of patients seen, just a flat salary, some other goofy formula. Is that becoming any less complicated or do you still see all these different methods of trying to figure out how much you're going to actually take home?

Ethan Nkana: I'm convinced that the industry of law is made up so that people intentionally cannot understand it unless you go through this rigorous three year training program. Yes, it's extremely complex. Could a doctor understand it? Absolutely. But the time that it would take you, I was looking at a family medicine doctor's RVU bonus structure, and it was the wonkiest thing I'd ever seen. And I'll spare you the gore of how bad it is. But the point being, it's unlike anything else I've seen in the country. And so, this one organization has this bonus structure that's disadvantageous to the doctor and she has no recourse to change that. One, she didn't understand how it worked, which, how could you? It's so dense. And then secondarily, when I explained to her, "Hey, this is not in alignment with the industry standard and it's disadvantageous to you", how do you think she feels? It's miserable and it's unfortunate that we don't do a better job of making it plain.

I think what doctors appreciate about working with me, it's that I'm not a practicing attorney, I'm an agent. So, how I talk to you is different. How I interact with you is different. I'm not charging you when you call me. I get a bill from my attorney if I send him a text message or if I send him an email. Again, no disrespect, I have an attorney for my business, but it just seems like a really unsustainable way to add value for my doctors.

John: Well, let's take it one step further than what you described. Maybe you have someone who was in this job, they're unhappy and miserable, now you're helping them. They find out they can't understand the structure, they're never going to get a bonus because they don't really even know what to do to get the bonus. And the hospital is just not budging. To me, that's like, "I know it's tough, but maybe this is not the place you should be working. At the end of the day, we can find you a better job that's going to pay more and it's going to be more transparent." I would think physicians are in enough demand, that they would be able to within a reasonable distance, find a different job.

Ethan Nkana: Yeah. Where were you when I started this out, John? You are preaching exactly what I believe to be the reality for doctors is sometimes you need to go to grow. And I'm not saying that you should go into a contract negotiation, willing to cut ties. But the first question that I ask a doctor when we're getting ready to work together is let's say you present your employer with very reasonable requests and they say no to everything. What are you going to do? And if you say, "Well, Ethan, I'll just go back to work tomorrow and do what I got to do", cool, I'm not a good fit for you then. We work with doctors who say, "Ethan, I know that I'm worth more than that. I know that I deserve better. My patients deserve better, my family deserves better."

All right, here's what we're going to do for you. I'm not going to waste your time as a doctor or my time by talking to your employer until I have an offer for you from somewhere else for more money and better terms. And then I come back to your employer and say, "Hey, Dr. J is looking for a nice little salary bump, he needs an extra PA for his practice. We need you to make those changes for him going to this new contract." They're going to say what they always say, "Not interested. - Okay, cool. Just so you know, Dr. J has an offer across the street for more money and better support. If you're not willing to pay, he's going to walk. - Oh, hold on, hold on. We can have a conversation about this."

Because now they know the economics of Dr. J moving across the street. And what they count on is Dr. J doesn't know his economics, but I do. I know exactly what your work to this hospital and conversely I know how much it would mean at another hospital in your area if they had you working on their team.

John: Now you said something earlier about the non-compete and the fact that you know where you're going should be able to buy you out of that in some way. Now the contracts I've seen have actually never had a dollar amount attached to what that would be. They're just a threat. "We're going to take you to court. And it says here you can't work within 20 miles and you can't work for anyone under this other system." That makes me think, then your contract should always have a figure of how to buy that out. Is that kind of what you're saying?

Ethan Nkana: Exactly. Typically contracts will. I won't go off the deep end about the legality of non-competes and whether or not they're enforceable because there's lawyers who spend their entire careers researching and understanding that. And that's just not my world. For me, it's more a matter of practical implications. I want my doctors to be able to violate their non-compete with no penalty. That's my goal. I don't care about "Is this enforceable?" It doesn't matter. Well, I'm going to assume it is enforceable and get you a route around that. I think it's important for doctors to know that, exactly like you said, Dr. J, there should be a finite number in there. If there's not, it's not going to be harmful for you necessarily. But the point being, that's going to be the amount that you are going to need to cover if you violate your non-compete.

And then again, here's the cheat code. Tell your new employer, "Hey, I've got this tail that I need covered for me. Can you help?" They're going to say, "Cool, we'll pay you that bonus, but you have to work for us for three or four years" or something like that. So, you can get around it. And I've worked around non-competes with new employers. But it's just something that when I was a hospital exec, I used to scare doctors with non-competes. Well, you don't want to upset the CEO because they might come after you. You know that's in your non-compete area. And of course, it has a chilling effect and doctors won't try to. I had a general surgeon last week who didn't feel like she could make that move because of her non-compete, despite me explaining exactly how she can navigate that.

John: I could go on all day with questions about the contracts.

Ethan Nkana: Let's do it. I got all day.

John: Oh no, something else occurred to me. How hard should you push for a notice? I've seen notice from three months to six months to a year. And to me, if you're miserable and you're ready to go, I don't know, waiting a year, and maybe again that's another buyout, but where do those usually fall on your clients?

Ethan Nkana: My goal is usually 90 to 120 days. And the reason I say that is because that's your one runway to find a new job. Let's say if you want to leave, you give them 30 days or 90 days notice, there's no harm, no foul. You're able to go practice where you want. The more impactful situation for doctors or detrimental is when the employer says, "Hey Dr. J, we don't need you anymore." And then now what's my runway to making my next dollar? You don't have that stability. And God forbid, if you're a primary breadwinner for your home, that can be devastating for doctors.

So, it's super important to make sure that you have a nice little runway. Typically what you'll see is it'll say the hospital or employer will give the doctor 90 to 120 days notice, but we can tell you, you're done as of today. But they have to pay you that full runway amount. So, that's the other thing to think about is they can still let you go right away, but they still owe you that notice period amount of pay, which can be significant for you.

John: All right, one last quick one.

Ethan Nkana: Let's hear it.

John: Tail coverage was always something... I was on the other side, again, I was pushing that you have to pay as much as we could get you to pay, and then the contracts we'd shoot for, all of it or have a reducing amount based on how long you've been there. But do you get contracts where you just say, "Look, it's a cost of doing business, I can't work if I don't have insurance, I'm not going to pay it." Do some institutions accept that these days?

Ethan Nkana: What I tend to see across the country is kind of two primary approaches. The default I would say is the employer is going to pay for tail coverage in some of these large healthcare systems. The exception to that is when I see private practices, that's where I tend to see more of the doctor has to cover 100% or the large majority of the tail coverage. And by no means is that a rule or research. That's just kind of my anecdotal observations. What I shoot for, for my doctors in any setting is employer covers 100% of tail insurance. I won't get into the intricacies of occurrence based first claim space, but just know if you need tail coverage insurance, there's kind of the primary default, which is your employer should pay that.

The other approaches I see is, the other bookend is the doctor pays the whole thing. But in private practice, what I'll sometimes see is the employer will cover more tail the longer the doctor's there. So, let's say the employer will cover 50% tail, but after two years they'll cover 100% tail coverage. The sensitive, weird thing about that is you're talking about when you end the relationship, but it's super important to talk about that because it's not something you want to have to find out the hard way that is disadvantageous to you.

John: Yeah. And the thing that I remind physicians about it, particularly if they're looking at their first contract, the tail is very low when you've never seen a patient since you're training. It's only when you've been in practice for a while where it can skyrocket. Eventually if you're an ortho or OB or whatever, it's going to be enormous. We had one guy at our hospital, he just walked away. He didn't pay it and he wasn't going to pay it. And I think the hospital had to protect itself by paying it even though it wasn't in his contract. I wouldn't recommend that approach.

Ethan Nkana: Yeah, likewise, I would not tell you "Walk away and not pay." Yeah. But that is one way to take the most aggressive approach. It's like, "Man, I'm not going to do it. What are you going to do?"

John: Yeah. All right, we are going to run out of time here. I want you to spend a little time, again, talking to us about your company. It's RMPA. rmpa.co is the URL for Rocky Mountain Physician Agency. Tell us more about that.

Ethan Nkana: Yeah. I think the cool thing about what I get to do for doctors is I'm not a traditional law firm or attorney. While my background is I'm trained as a lawyer, I have an MBA, I spent my entire career working in hospitals. And so, what that's allowed me to do is create an industry where we represent doctors the same way agents negotiate talent deals like artists, musicians, movie actors, professional athletes are the common one for me. And so, the cool thing about my work is I get to see doctors at the beginning of their career and help them negotiate a really strong foundation. And at the same time, attendings come to me and say, "Hey, I don't want to get screwed on another contract. Can you help me make sure that I get the best deal in this next contract?"Or physician groups will come to me and say, "Ethan, there's four of us, 10 of us, 20 of us. We have crummy contracts, crummy conditions, but we don't know how to get the attention of our employer." And so, that's where I come in and say, "Look, you get back to doing what you do best, which is taking care of patients, and I'm going to represent your interests to make sure that we address all of your concerns."

And as you know. Dr. J, doctors are not a monolith. If you have 10 doctors in a group, it's not 10 doctors who are all prioritizing the same things. Some of you are going to be in different stages of your career, so you may value different components of your contract, your job, or your lifestyle. And my job is to help take those priorities and interpret them in a way that your employer can understand and make sure they're in your contract for you.

John: Now, you alluded to this earlier, but we didn't get into detail about it. But basically when you're engaged, your plan is to put the onus of the payment on the employer, which is most of us have not gone that route. That would tell me that maybe there's a timing issue here. We're not going to bring you in at the last minute. When would be the best time for either a new physician coming out of residency, fellowship or someone who sees their contract up for renewal in a year or six months? When would be the best time to talk to you?

Ethan Nkana: Yeah, good question. I would start by saying if you are an experienced doctor, you should renegotiate now. Unless you've negotiated in the last six months, nine months, 12 months, you should renegotiate your contract now. Because the chances are you probably haven't had a salary raise in the last 2, 3, 5 years, which means you're taking a pay cut. So, experienced attendings, I would say call me first. And I only say that because as we were talking about, I think we're recording this Dr. J, but we're not a good fit for every doctor. I'll be the first one to say, "Hey, if you are a doctor who only wants to work in this specific hospital or setting and you're not willing to consider your options", I'll be the first to tell you we are not a good fit and we're not going to meet your expectations.

The doctors who are a good fit for us are the doctors who understand that they deserve better. And they call me and they say, "Ethan, I'm frustrated. I'm frustrated with my practice, with not having enough support, with not having enough resources. My staff is not supported." Those are the conversations we can help talk you through. You just want us to give you the answers to the test. We'll be happy to do that. And in fact, we do that. We'll be with University of Michigan next week doing a workshop for them on how to go from training to your first job and make the most out of it. My view of it is call us first. Send us a note first and we'll help you help lay out the roadmap for you.

But I say for experienced attendings, you should renegotiate now. And I know it's going to feel awkward. "Well, my contract is not up." Renegotiate now. If you wait until it's up, you're going to be too late and the hospital is going to slow play you, which they love to do. And then if you're a first time attending, I say that the appropriate time to start looking for your job is about nine to 12 months from when you're finishing training. Typically you'll finish training June, July timeframe. So, nine to 12 months before that is when you should really in earnest kind of get the job search started and then looking to sign a deal in the spring so that way you can do the onboarding, HR, drug tests, all of that. And then potentially you might relocate. So, you'll need to consider that as well.

John: The people I talk to are usually pretty miserable. And so, have you ever been involved with someone who says, "Look, I am in the middle of my contract. It may be a three year contract, or maybe I'm early, it's been a year. I need to renegotiate it now, as you said." But have you had it where they said, "I am going to invoke my need to give my notice. I'm going to give my 60, 90 whatever, 120 days notice and it's not because I want to leave, it's because I just want to talk to you about getting a better contract." The employers, do they respond okay to that?

Ethan Nkana: Yeah, that's a really interesting perspective. I haven't considered that before. I haven't seen that exact situation. I always tell my doctors, whether they work with me or not, get a safety net first. Before you go to your employer and invoke your notice or say, "Hey, I'm going to leave", get an offer first or get some interest first because that will allow you to have, one, some confidence because you can actually back up what you're saying. But secondarily, it gives you a soft landing spot. In case you need it, you really need out, you'd have a landing spot that would allow you to have an uninterrupted livelihood and an ability to make a living. So, if you do put in your notice, I would say go get an offer first.

John: Makes sense. All right, one more time, what's the website and maybe the phone number if you want to give us that too?

Ethan Nkana: Yeah. The phone number is (720) 471-0059. My email address is ethan@rmpa.co. And then we're on Instagram and LinkedIn. We're also starting our new business YouTube page, where we have given a bunch of free tips on how doctors can advocate for themselves in contract negotiations.

John: Very good. Any other last thoughts or advice for us before I let you go? I'd say let's talk about the new grads that are coming out. Just any other things you want to leave before we get out of here?

Ethan Nkana: I think one of the most common misconceptions about first time attendings is that they do not have the ability to negotiate. And I want to be the first one, hopefully, to break that myth. Every one of the doctors that we work with makes more money in their contracts. It's a matter of asking, knowing how to ask and what to ask for. For the first time attendings coming out, please do not feel as though you have to sign whatever is put in front of you. I said a thousand times as a healthcare executive, "It's a standard contract, you can't change anything." And guess what? Doctors didn't change anything. I want to encourage you, please advocate for yourselves, know what matters to you most and ask for those things in your contract.

John: Excellent advice. I really appreciate that. Well, I guess that's all we have time for today. Ethan, I'll have to have you come back someday but this has been fantastic. I've learned a lot. With that, I'll say goodbye.

Ethan Nkana: That's been a blast. Thanks Dr. J.

John: Bye-bye.

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The post Negotiate a Great Contract, Avoid Burnout, and Be Happy appeared first on NonClinical Physicians.