Ep 42: Know What You Are Signing with Dr. Lara Hochman

After sacrificing more than a decade of our lives to obtain clinical privileges, many physicians are unfortunately feeling stuck in our jobs and unable to help patients. 

As physicians, we dedicate our time and energy to advocating for patients. Yet if we fail to advocate for ourselves at critical times, we may end up in workplace cultures that create barriers to practicing medicine.  Rather than putting our heads down and accepting the status quo, we can each do our part in improving the workplace culture by:

💪 Seeing the value of our own time, energy, and talent.

💪 Approaching every job interview with curiosity and an open mind. 

💪 Reviewing the employment contract thoroughly.

💪 Not ignoring terms that raise red flags.

💪 Knowing that signing a contract is always a choice; not signing is sometimes the better choice.

I loved this conversation with Dr. Lara Hochman, a Family Physician, who is also the Founder and CEO of Happy Day Health, a matchmaking service to connect amazing doctors with high-quality physician-own practices.

Go to this week’s Dare to Dream Physician Podcast episode to hear part 1 of this empowering conversation on workplace culture. 

Dare to Dream Physician Resources:

Dare to Dream Physician, Life Planning for Physicians

 https://daretodreamphysician.com

Dare to Dream Physician on Facebook

 https://www.facebook.com/daretodreamphysician/

DreamPhysician on Instagram

https://www.instagram.com/dreamphysician/

Resources for Dr. Lara Hochman:
Happy Day Health
http://happydayhealth.co

Lara Hochman MD on LinkedIn
https://www.linkedin.com/in/larahochman/

Transcript

Dr. Gray, Host 0:00

Welcome back to another episode of the dare to dream physician podcast. I'm so excited today to share this topic and also to introduce our guest. Her name is Dr. Laura Hochman and she is a family physician and founder and CEO of happy day health. For any physicians who go to work and care about what your day is like at work. And just overall the experience of being a physician, practicing medicine, you are going to love our conversation today. It's going to be so valuable. I also want to put in a disclaimer that everything we discuss in this podcast and all of my podcasts episodes represents the personal viewpoints and opinions of my guests and myself, and do not represent any views or opinions of the organizations or institutions that we are affiliated with. As always use your own judgment when it comes to your personal and professional decisions. Please help us welcome Dr. Laura Hochman.

Dr. Hochman, Guest 1:01

Thank you for having me. I'm so excited to be on this podcast. I love dare to dream positions. Yeah. I'm the founder of happy day health, where I'm working to help on a smaller scale, help doctors match with private practices where they're a good fit and where really there are a lot less likely to burn out. on a larger scale, I'm working to change the culture in, in workplaces for physicians.

Dr. Gray, Host 1:31

Wow. Wow. Those are such admirable goals. And I think, as a physician who, as an employed physician, it's one of those things where you're like, wow, I'm so glad someone's doing that because, I'm too busy seeing patients. but I think it's so important because It's what's going to keep medicine going, I think most of us went into medicine because we want to help people. And when you start, when you signed up for this long training to help people, and then at the end of the training, you get out and you're like, wow, I don't know if I can help people. Like I know how to, but the, the system and the constraints that we have, make it very difficult for me to do that. And I think that is the workplace culture that you're referring to. so I'm so glad that somebody is working on that. and, tell us a little bit more, so you want to change the workplace culture and you're doing, you're starting this, on a small scale. why don't you just tell us a little bit about, how did you get there? you're a family physician, how did you get from that to now wanting to save the world through changing workplace?

Dr. Hochman, Guest 2:34

Yeah, being a family physician, I was able to experience it and know exactly what was going on because I was in it. And one of the things that I noticed, just like you're saying is that as doctors we're too busy to do anything about it. And whether it's lobbying at the Capitol, we, we were having struggling to cancel patients to go advocate for ourselves or within the systems where we were working, all the committees or anything. We were too busy taking care of patients. And I think that's, what I noticed is that's a big part of why. We're in this position. We are because we haven't had a seat at the table. We're too busy taking care of patients. And as more and more administrative burdens and metrics are thrown on us, the more busy we become and the harder it is for us to advocate for ourselves. within that framework is when I realized that we are signing contracts with big systems that are quite frankly abusive. I looked at one of these contracts because I was considering working for a big system and ended up walking away from the contract entirely because there was zero negotiation. They did not budge on anything. And I had, lawyers write very reasonable things to replace some of the things in their contracts that were still fair to them and they just wouldn't budge. and so that's. started to mull over what can I do to be a part of this? I was still too busy seeing patients in my new practice, to really do anything about it. But what ended up happening was I actually loved where I was working and helped to recruit physicians, to work in the company with me, and then word spread. And then other practices asked me to help them find physicians for their practices. And so I did that and it took many hours to find these physicians for my friend's practices, but it was so rewarding. I was finding doctors that were very burned out and very unhappy. And one was even in the middle of a litigation from, a very unreasonable litigation from her employer, and put her in somewhere that she just loved working. And so it was so rewarding and that's when that idea came up, this is how I can change it. And within that framework, I can also advocate for physicians. And, even if I'm not placing a physician in a practice, I can still speak with them and help teach doctors what to negotiate and how to negotiate and, and make a difference in that way. There's so many things that need to be done, but this is the way that I'm doing my part.

Dr. Gray, Host 5:12

Wow, Laura, I love what you're saying. So you're basically saying that you stumbled into this, in that. were minding your own business and doing, as a family physician, and then you're looking out for your friends and let's just looking out for, to recruit more people to work with you. and then you started noticing, wait a minute. there are some issues with, which, you know, at the time you may not have called that workplace culture, now in retrospect, we could probably call it that.

Dr. Hochman, Guest 5:37

Yeah, absolutely. And, you and I haven't spoken before about. Is trying to be done for work workplace culture, which is do yoga, do meditation, which is all great. But unless you fix the system, that's not going to be all that effective.

Dr. Gray, Host 5:54

So when you say fix the system, what, how do we do that? I think most physicians who are listening, will agree on something, needs to be done to the system. Something needs to be fixed. This is not a sustainable system for physicians. This is probably not a sustainable system for patients either. And it, something needs to be changed, but what is that? how do we it's so overwhelming when we think of, okay, we need to fix the system. How do we fix.

Dr. Hochman, Guest 6:21

That's the million dollar question. I believe that it's fixable. I also believe that things have been getting worse and worse and worse over the years. And we're at this precipice that. Where we've crossed the threshold, where enough of us have realized that something needs to change and are working to do something. So in order to fix it, I think that we all need to do our part. And so whether it's something gigantic like I'm doing, which is starting a business with the sole purpose of helping physicians, that's great. Or it can be as small as when you are negotiating a contract with a system, really take a good look at that contract and advocate for yourself. And there's so many things in between those two extremes that can be done. Stand up for yourself, negotiate better contracts, go speak with your senators or congressmen about things that need to be changed. And negotiate with insurance companies. Unfortunately, one option is just, don't take insurance. There's so many things that can be done. We all just need to do a little bit of something. And if enough of us do it, it will slowly start to turn the wheel and things can get.

Dr. Gray, Host 7:42

I love that. I love that. What I'm hearing is it starts with questioning the status quo. It starts with just one thing, and out of the things that you listed, I think the one that perhaps, the audience can see. Really hold onto is the contract. so let's talk a little bit more about that. Cause you cited an example of, when you had a contract that you decided not to sign and I want to bring that up because that is very admirable by the way, because I'm just thinking, I'm, my seventh year as an attending and I'm just remembering, when I was new graduate, looking for a job. I was, I was of the mindset that, wow, if someone gives me a job, that's great, and I think that's probably a fairly common mindset. and, and it, I definitely have evolved a lot since then. And, don't think about it like that anymore, but I don't know if physicians in general realize how important that contract is and because this podcast is about daring to dream and pursuing our dream life. when you look at a contract and you decide to sign it, that has ramifications on your life. it's not just this piece of paper. It has ramifications on where you live, Especially if you decide that, oh, I want to end this contract. it has verifications on whether you can even do that. and of course, how we use our time, in, in life planning, we talk about, your four assets, you have your money, your time, your energy and your talents and whatever piece of paper that we called, the contract that you signed is going to have ramifications on all of that for your life. And we really should take it more seriously than we do. I think a lot of us, like you said, especially if we're. Dealing with a big organization, like an academic center. And a lot of us are probably told this is a standard contract. There's really nothing to, talk about, just here, look and sign it. a lot of us would just say, oh, okay. All right. And then we sign it without even maybe knowing what's in there. so tell us a little bit more about, how you experienced that, because I think people need to hear that.

Dr. Hochman, Guest 9:52

Yeah. So they gave me the contract, which had a crazy noncompete and, an intellectual property clause that basically said everything I have done or will ever do belongs to them. So those were the two sticking points in that contract. And just looking at the non-compete, I know that life is hopefully long and I didn't plan to ever leave the city that I'm living in. But if anything were to happen where I left that system, I would have to pick up my family and move there's no way, or just be out of a job for two years. that was not an option. And the crazy thing is, the other physicians that I worked with when I asked them why they signed it, they're on. So it was like you said, I didn't have a choice. And the hospital, when I tried to negotiate with them, they wouldn't budge that at all, just not at all. And when it came to the intellectual property clause, at that time, I had another business, which I still have. And. They're onset to me about me not wanting to put in the contract. My business belongs to me is well, but the other doctor assigned it. So you'll be fine. that kind of made me realize that they're able to do this because enough doctors are signing these without any question. And so the more of us that question it and the more of us that push back on what is really quite abusive and very one-sided, the more they'll have to negotiate. They won't have that choice because if they just say, Nope, this is it. They're going to have a very hard time attracting physicians.

Dr. Gray, Host 11:43

That is so important. I'm so glad you share that because we're very, well-educated, we're MDs and then we have post-graduate education and residency and some of us in fellowship, but did we ever get training on contracts?

Dr. Hochman, Guest 12:01

We really didn't and if we did, it was one lecture, maybe when really all I was thinking about was I have a patient to take care of, get me out of here. So yeah, we need to be learning about these things for sure.

Dr. Gray, Host 12:16

Yeah. Yeah. I love that. I wish we could just shout that from the mountain tops. And, I think I hear this a lot from people who are, looking at, a job either as their first job out of training or, in a job transition as an intending that they're worried that if they ask questions, if they, just like you did, I'm like, oh, can we make this work? this part I'm really comfortable with this part. Can we make that work? They're worried about being perceived as. Uh, disruptive physician or the trouble person. And what do you say to that? Because I have thoughts about that, of, really what I want to hear, what, your thoughts about that.

Dr. Hochman, Guest 12:56

I say, be that person close trouble. Do it.

Dr. Gray, Host 13:02

I love it. how about, sharing with, okay, so what happened? So you basically said, you asked these questions and it wasn't negotible, so you decided that you are not taking this contract. was your life over, did you get labeled as that trouble physician? And then we got on the street and then you weren't employable anymore. What happened.

Dr. Hochman, Guest 13:20

Oh, it was the best thing that ever happened to me. I, I walked away. I had, I did not look for another job at that point. I was like, I guess I'm a stay at home mom now. And this other job fell into my lap. Two months later, it was the best job I could possibly imagine. There was no non-compete in it at all. It was, I was so happy and I absolutely. I remembered what it was that I loved about practicing medicine. I met the coolest people. it was great. So my life did not end in fact, my life got better, and gave me new perspectives, which is really cool. And a funny story is that there was a lawyer that helped to write the rewritten parts of the contract to, of the one that I ended up not taking. And I met with him a few years later and he said, oh, how did things go with this hospital system? And I was like, oh, fantastic. It was the best thing ever. And he says, oh, so you like working for them? No, I don't work for them at all. it was great. It was wonderful. I found a place that actually treated me well and respected me. and I think you can tell a lot about a practice and a company by how they negotiate with you. It's very indicative of how they are going to be as an employer. So it all worked out in the end better than I could have ever met.

Dr. Gray, Host 14:49

I love that. I love that I have a very similar story because when I was, graduating from fellowship, I started looking for my first job. And, my husband, I were trying to think outside the box, like, where do we really want to live? cause we weren't stuck to one place. And so we're like, wow, like this place would be a dream. Like we had vacation in this area and we thought, wouldn't it be cool to work there and live there. Contacted that hospitals like a cold call, cold email, if you will. And, and there were actually like, I didn't think anything of it, but then, then I got a phone call. and, this doc was talked to seem really great, really nice and was like really interested and everything seemed great. And they actually, flew my family out there. and it was wonderful. And there were, of course, in retrospect, there were parts of this interaction. It was great with one group of people with the physicians, but then, it, it was a little bit different with, the administrators, I mean, Bad is just, a little bit different of an interaction in any way. So it came time to, to have a discussion contract, like a draft contract. And so they had their lawyer drop something and I was reviewing it. And granted this place that we would have gone to was really far from either of our families w would have been in the venture for us. And one of the things that was in the contract was. that I could be sent, to, to any of their satellite locations, which, at this hospital could have been like three plus hours away. and I looked at that and I'm like, this wasn't really discussed when I talked to the physicians about the practice. And, this wasn't really discussed when I met with the CEO, this is interesting. And so I asked him a little bit more, basically long story short, even though this appeared to be my dream job in that was a non-negotiable for me. And I just felt I had to be honest. I couldn't be like, oh Yeah. this will work for me when it really wasn't going to work for me. And so I just made it very clear to them. And, that we ended the discussion there. That was the first time I had, like a contract in my hand. they show me the dollar amount and of course, as a fellow, you're like, wow, this is a huge pay raise, And then it was gone because I was like, oh no, I can't do this. So it was a little bit emotional when it happened, but I moved on just like you, I didn't get blacklisted. I guess I did with them because I told them I can't do this, but it didn't matter because I interviewed a lot other places. And in the end I found a job that, that didn't require me to, drive three plus hours away. And, the contract itself, the language was much more favorable. the people who I was discussing with, like you said, was w was great. I, you do, it's so true if you open your eyes, if you open your mind to when you are. As a physician, when you look for jobs, you're interviewing them as much as they're interviewing you. And it's not like an ego thing. It's more it's more like a marriage, right? Cause I know you sometimes call yourself a matchmaker. When you're talking about recruiting physicians, it's is this going to be a good fit? and so think about who you are, right? So if you are somebody who's just going to go with the flow, whatever people say you're going to follow, okay. You can act that way during the negotiation, just take whatever contract you want. But if you're someone who wants to know why things are being done this way, or, maybe want to be really engaged as a physician, you may actually have leadership qualities that you didn't know about. And when you show up to the interview, bring that about yourself and in a way, not in a way. Offensive, but in a way where, you're curious or you're, you're engaged. And I think that will show up as an asset, you know, as someone who now interviews candidates I love it when I meet physicians like that. And I also want to know if they're not going to be a good fit, I don't want them to pretend to be a good fit and they'll be really unhappy when they come here. so I love that you gave an example of how it was look the best thing that happened to you that you decided not to take this contract because it was so similar to the experience that I had no seven years.

Dr. Hochman, Guest 18:38

Yeah. Yeah, that's huge. And you bring up so many good points, in the interview, you're interviewing them too, which, unfortunately it does come across sometimes as very arrogant. but,

Dr. Gray, Host 18:50

I'm going to share a thought about that. Cause I think that is a very common mindset, but people go in with oh, if I ask them questions, I'm challenging them. And here is the thing I don't think about it that way at all. I approach it with curiosity. I'm, one of the questions I asked when I interviewed at places is, tell me a little bit about the culture here. what's it like, what's the relationship between physicians and administration? what is it like? What do you like about working here? And these are. It's more curious questions. It's not challenging questions because it's an it they're open-ended. but what people say and what they say on record and off record, I'm listening the whole time because you learn so much about a place when you observe, they replace. And it's all about that workplace culture. It's the feeling that you get. you might be collecting all this, all these sentences that people are saying and are maybe not saying, and then at the end of the day you get a feeling and you're, in your gut, oh Yeah. this feels right. Or this doesn't feel right. And I've gone to places where I've interviewed where I'm like, I want this place to feel. Right. Because I really want to move there. And then I'm like, I can't fool myself. this doesn't feel right. And so I think so. I don't think, I, haven't gotten feedback that when I approach it this way that people think of it as arrogance, right? it's the attitude that you approach it with too. It doesn't have to be arrogant at all. Cause it's not is this place good enough for me? It's more, I want to learn more about this place and is this where I picture myself? And is this, was this a mutually good fit?

Dr. Hochman, Guest 20:22

no, I agree completely. I think, if you don't ask questions, it comes across as an interested, but also you want to know that you're picking the right place for you. I have had feedback, from one physician that was interviewed that came across as arrogant. Not because he asked questions, he should have asked questions, but more because of how it came across as in, I'm interviewing you and. I, the candidate I'm interviewing you in a way that is very me centric and how can you help me rather than how can we help each other and be beneficial. And it's better that he doesn't match with this practice because personality fit is so important. You really want to match the personality of your culture. And that candidate would be great somewhere, but not in the small practice that, that he was interviewing. And, it is so important to ask questions because you need to know. And again, it really does look good. I love interviewing people when they ask questions about a practice and, sometimes when people ask, they're afraid they are afraid of coming across as presumptuous or arrogant or. Not interested, but these are all good questions. And the most common question to go back to what we were talking about earlier, that people are very afraid to ask us about the non-compete and it's always qualified with, while I want to do this forever. I just want to be sure to protect myself. And then they ask about the non-compete, which is really wonderful. There's nothing wrong with asking about a non-compete because you need to protect your future self because you don't know what's going to happen in the future.

Dr. Gray, Host 22:08

Yeah. And it's so interesting, th the fears that people have going into the interview, because, having sat on the other side, enough times and, maybe I'm, everyone's different. So I'm not saying, assume that the person on the other side is the same as, one person, but it's. you like, for example, I know, this is just another example, if someone was interested in the maternity leave policy, I would be happy to share with them because, if you're, a young female and I would assume that you want to start a family. you don't have to, but it's one of those things where it's I just remember it's this hush thing, if I'm applying to a place, I don't want to ask about their maternity leave policy because, then they know I might want to get pregnant, but it's it's obvious, to the other side, you almost expect that, If someone wants to start a family, that's a normal part of life. And, and then, a work culture that is supportive, would expect those kinds of questions. And that may not. Best example. Cause I know there's some legalities around those types of questions, but that's just one example, the other perfect one is the non-compete I don't think anyone should approach that with fear because just, think about all the, I mean you can, before you asked, you can think about all the other things that are out of your control, that you would want to leave this place, Even if the place is the perfect fit for you, you know what, if you have a sick family in another state or, what, if you're, you have a child that needs a higher level of medical care that this local hospital can't provide. I there's so many things that are out of your control and you approach it with that attitude as opposed to oh, this is hush. Like I feel bad even asking, but just, be natural about it. There are things that could happen in life. I would love to find a workplace where I can stay forever. But if there are things out of my control that where that can happen, I just want to better understand this policy. And so it's so interesting how, I think the person who was sitting on the other side is probably more accepting of these questions then than we think as physicians.

Dr. Hochman, Guest 24:14

Absolutely. I agree. Completely life happens. You don't know what's going to happen. So prepare for anything.

Dr. Gray, Host 24:21

Yeah. And I, I think the more physicians show up with that confidence and that mindset, the more it's just going to be normal conversation. like you said, a lot of the things that you're, that, that employer who you didn't end up working with, they're basically saying we can do this because people are signing and people are not questioning. And so is that, is that the reputation we want as physicians, so that people can just give us whatever and we're going to sign it and not question it is that, yeah. We don't get business training in medical school, but is that the person we want to be? because it does affect our life lot affects our personal life, our work life. And, I think we're all worth it to, if we have to ask questions, we're worth that we're worth that energy and where we're at that time.

Dr. Hochman, Guest 25:08

I agree completely. and I'm going to go off on a tangent here a little bit off topic, but, I think the non-compete is a big part of why as physicians, we feel stuck. And so I see a lot of doctors who they feel stuck or they feel trapped and they're unhappy or burned out or whatever it is. And they. I feel like there's a way out, and then the non-compete is a part of that. There's so many factors. It's our responsibility to our patients are our need to please our need to help people. but a big part of it as the non-compete and something I see over and over again, when I'm contacted by doctors who are so unhappy and and that translates into family life as well, is that, they say, I'm stuck. I don't know. I can't go anywhere. And I just, I really want doctors to know you are not stuck. You are not trapped. There are other options. Life is not black and white. It's not practice or don't practice. There's tons of options in between. You're not stuck.

Dr. Gray, Host 26:18

so true. I love that. And I think so many people need to hear that. I know, there was definitely a point in my life where I needed to hear that.