Beyond ADHD A Physicians Perspective Ep 12: Lara Hochman, MD (Family Medicine Physician, Founder of Happy Day Health)

Dr. Lara Hochman: Most of us in medicine are perfectionist. Something I see all the time is doctors get stuck on making the right decision when. You can't really make the right decision. You make a decision and then you make it right. But you got to know that you're not going to make the right decision every time. If it's not the right decision.

That's okay. We tend to feel stuck in our jobs in medicine, and you're not stuck. You can absolutely make a change.

Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers for three and four years of age.

 

And in the past year, I have undergone radical transformation after discovery, ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished. And a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.

 

Hello? Hello. So excited today. I have an amazing friend and an amazing physician. I want to introduce her.

Her name is Dr. Laura Hochman. She is a family medicine physician, and she's an advocate for fellow doctors wellbeing. Of course, this burnout and dissatisfaction has taken a toll and she's here to save the day. She founded Happy Day Health, , a physician recruiting agency to match doctors with well run private practices where they can enjoy practicing medicine again.

And so it's such a great treat to have somebody who is looking out for our well being and more importantly, helping us get a job that fits our environment, but please tell me, how did you get into this? How did you decide this was what you were going to be doing? It seems like a big adventure.

Dr. Lara Hochman: Yeah, it's certainly a big adventure. Yeah. And thanks for having me on today. You know, I essentially fell into this job, or into this business. I was helping friends find practices where they'd be happy. They were burned out. I was doing it anyway on the side, just for fun. And I was helping friends who had practices find doctors because they could not find a doctor to join them.

I already had the thought of, I want to do something to help physicians. I can obviously see with my own eyes what's going on in medicine, and I want it to be a part of the solution. And so in doing what I was doing anyway, that's when I realized that I can make a huge impact by helping doctors find places that they're a better fit.

And, rather than trying to fit a. Peg into a square hole, it's find to fit the peg into a pink shaped hole. So, and so that's how I got started. I realized that I could make a big difference and you know, there's a lot that needs to be done and this is the way that I can play my part in us taking back minute.

Dr. Diana Mercado-Marmarosh: That's an amazing thing that you saw the need and you realize that this is what you enjoy doing anyways. So why not make it official? And everybody wins, right? Like private clinic, we'll get an amazing doctor. And the doctor knows that this is what they want because you, yourself being a physician, you are.

Gonna be trying to make a quick buck and just placing somebody somewhere, but you understand the ins and outs. So you have that deeper understanding that other people don't sometimes.

Dr. Lara Hochman: Yeah. Being a doctor. I totally get it. And, one of the things that makes us unique as a profession is that we go into medicine because we care and we want to help people.

And, I mean, I absolutely bring that into this business because that's who I am.

Dr. Diana Mercado-Marmarosh: So tell me, I'm sure there are some residents that are listening or even some medical students, or even some attendings that are already have a job, or maybe they're in between jobs. What would you tell them, how can one choose a job or how can they decide what they should do now that you know, there are that stage.

Dr. Lara Hochman: There's so many things to do. You know, the first thing to know most of us in medicine are perfectionist. And so something I see all the time is, doctors get stuck on making the right decision when. You can't really make the right decision. You make a decision and then you make it right. And you want to make the decision that's best for you, but you got to know that you're not going to make the right decision every time.

And so if it's not the right decision, that's okay. We tend to feel stuck in our jobs in medicine, and you're not stuck. You can absolutely make a change, but there, you know, there's so much to do. I would say if you're a medical student or just starting out your residency, or even if you're an attending and you're not ready to leave your job, the first thing to do is just.

Notice what you're good at notice what you're really good at notice what you're not so good at and really take note of those things, because that will absolutely play into what kind of job you should be looking for, what kind of job you would enjoy and what you absolutely want to avoid.

Dr. Diana Mercado-Marmarosh: People with ADHD sometimes tend to think outside the box. We sometimes tend to spend a little bit extra time with our patients because we don't have that time awareness sometimes. But at the same time, we're willing to be, you know, run diabetic groups or we're willing to do something else that's a little bit different or procedures or different things, right.

Like you just said to. Inventory of what your strengths are and what you want to do or not do, or if you want to do research or if you want whatever you're wanting to do, or definitely not do, like if you don't want to be on call, you know, then knowing, okay, that environment is not, or that job maybe is not the best fit.

And like what you just said about making decisions. That's the fastest way for us to move ahead. Like you said, because, not making a decision is still a decision that you made. Right. And so, we, we want to forecast innate at times because we're like, whoa, what if I messed it up? But what if there's no wrong?

Right. You just now have more data when you make the decision. Right. And like you said, then you make the decision, right. Either you signed a year contract and you go forth and conquer or you decide, yeah, this is not the right environment. And then you call Dr. Hoffman and she helps you out. Right?

Dr. Lara Hochman: Exactly. I mean, you know, like you said, there's so many things that, that doctors can do with ADHD. It can be a superpower. So, you know, don't, don't get stuck doing something you hate and that you won't thrive in find those things that you'll be great at. And more than likely. There's tons of doctors who don't want to do those things.

If it's business development or hiring or setting policies. Your ADHD can be an absolute superpower with the hyper-focusing and being able to get excited about all the different things and making something boring into something interesting. You know, that's thinking outside of the box is what we need in medicine.

So we really need more of these innovative things.

Dr. Diana Mercado-Marmarosh: Can you tell me a little bit, I know you've worked with so many amazing clients and I know you've been able to help them find the right environment for them. Like what have you noticed when you're working with clients that have ADHD? What kind of environment do they tend to thrive in?

Have you noticed any patterns?

Dr. Lara Hochman: Yeah, so,, with ADHD, you know, there's that distraction. Issue where you get distracted very easily and evolutionarily. It's been very beneficial and we've, we've selected. We've selected out for that because if there's a tiger running for you want to be distracted and run from the tiger.

So there's certainly benefits to that, but you want to make sure to maximize that. So. You know, in the back office, if there's one big office with lots of doctors, lots of nurses, medical assistants, back office staff on serving patients questions and calling patients with lab results. And people bombarding you with questions all day and prior authorization is being done and, you know, nobody can focus in that environment and, and especially if you have ADHD, so.

Typically, you know, if you have ADHD, you'll do better if you have your own office or if you're away from a window, and if those things aren't necessarily possible, what accommodations can you make? You know, without necessarily making accommodation. So is it that you need sound canceling headphones?

Do you need to set better boundaries where your medical assistants, if they have questions, they don't come ask you every time they have a question, they batch those questions and every day at 1:00 PM, before you, while someone else is rooming your patient, that's when they come to you with that batch of questions.

And so rather getting a scheduled, scheduling it into your schedule is far better than the constant distractions. So part of it is, is this practice better set up for you? Do you absolutely need a scribe? Do you need someone like Dr. Diana to help you with, with how to manage your ADHD, um, in, in a practice setting?

 Or is it. Not the right environment for you at all. And is this perhaps not the right practice for you?

Dr. Diana Mercado-Marmarosh: Yeah, you're so right. You know, whether you have ADHD or not, we all get distracted. With distractions, right? If somebody is knocking at your door, which they, they would, for me, they would knock on my door as I'm seeing a patient and they will pull me out so that I could sign like a referral or I could sign like physical therapy order or something like that was obviously not an emergency.

That would distract me. And then you go back into the room and guess what? Your patient has five additional questions. When you thought you were about to close the encounter, right? Like you just said, learning to set boundaries from a place of like, no, I made this decisions ahead of time. Do not distract me.

Unless, literally the, the window is like on fire and the whole building is on fire and then I can't escape then come distract me. Right. But other than that, send me a text and I will get to you at certain time. Right. If it's not urgent and having that understanding of how your brain works, that if you have some boundaries, like if you already said, okay, we're not going to take every walking patient, like we're going to, set up some urgent care appointments, sort of say like shorter 10 minute appointments at the beginning or at the end of the day, or we're not going to see like double books, because then I don't need understanding if that environment is feasible. If they respect what you're asking them to do. Like you're not asking them for anything other than a lunch. Right?

And sometimes. It doesn't seem like you have that environment and it could be very different. Like I know when I was at my first job and that's another thing that's important to point out that sometimes your first job is not always going to be your last job, right. Sometimes it's just, you're there for a year or two, and then you learn what you like, or don't like, And then you can move on to another job.

And it's not just about the money. We all know that because it's how they treat you. Right. If they respect your opinion, if they give you your boundaries, if they give you your vacation, what kind of benefits you have? I know in my first job that I had. They had amazing maternity leave. Like you could be out three months, like paid and then you could be half paid for additional three months, which I, like, I had never heard of something like that.

Of course, when I came to my current job, they didn't even have like anything. Like it was, you get FMLA and that's it. Like you are not going to get paid, but of course I was able to negotiate and that's something that is important to know that sometimes. You can negotiate things that are not necessarily in the contract.

If it's something that. Important for you. For me, I didn't have kids at that point. And it was very important for me to have three months paid off. Now I didn't get three months paid off, but I got eight weeks paid off. And then I could use my four weeks of my own sick time, which win-win, you know, I was still going to take it, but why not take it paid right?

The point is that again, you have to understand. Your environment. And like, I was able to tell them up front, like sometimes you're not even supposed to be talking about that. If you're going to get pregnant or if you're pregnant or whatever. But to me that was so important and I told them, Hey, listen, I am going to get pregnant at some point.

And I want time off paid off. And so they gave me a one-time deal, but of course, then the second one came around and they came and they offered it to me without me asking. And so that's amazing that type of environment. Cause I, assumed we already had a contract, then that's what it was. But again, an environment, when I finally got pregnant, they send me flowers and they're like, congratulations, you're pregnant. Right. Which doesn't happen in some jobs. Right? Like in other jobs, you're just like one of 200 doctors. And even though you want to change or provide a way to change, you're easily replaceable and it doesn't matter what you say.

Dr. Lara Hochman: Absolutely. Yeah. And you bring up so many good points in there, you know, you don't want to be one of 200 doctors because then you may not have those opportunities to use your strengths strengths. And as far as finding a new job goes always negotiate. But before you even get to that point, you want to think about what are your deal breakers?

So if a fully paid maternity leave is a. Is an absolute must. Private practice may not be the best option for you because you don't have the entire hospital system to support your maternity leave versus in a small private practice. If it's you and one or two other doctors, that's not really financial feasible.

 So you really need to weigh the pros and cons of each, you know, how important is a paid maternity leave versus how important is an office. That'll send you flowers and, and that's like a family, you know, there's so many amazing private practices where they function essentially as a family.

And you can get that. In some hospital-based clinics. But it's certainly a lot more common, in private practice because everyone's invested in the practice for sure.

Dr. Diana Mercado-Marmarosh: And yeah. And of course, I asked I was still going to assign, regardless whether they said yes or no. Right. But you don't lose anything by asking.

Right. And so that's a thing. And even if they would have said, no, we're not paying, I still wanted to make sure I could take the three months off. Right. So like those sorts of questions. To ask and, and you don't know what they're going to say until you ask, so don't tell yourself no, right? Like that's the no, no, like don't just assume things because that's the fastest way to make an asset a you and me assume that's what it spells out.

So just ask and, and then if it's not meant to be no worries, but at least you asked right.

Dr. Lara Hochman: Exactly and that's something that was kind of beaten out of us in medical school is asking for what's important to us. And that's so important because if you don't ask you, the answer is definitely no, it may still be no, but it may be a yes. So definitely ask.

Dr. Diana Mercado-Marmarosh: Let me ask you a question. Like, what else should they be thinking about? Should they be like looking at if they have 401ks or if they give three weeks vacation, four weeks vacation CME, what other benefits should somebody be looking for?

Dr. Lara Hochman: You want to look at, so certainly paid time-off, that's an absolute must. You need to decide how much is good for you. I had one candidate that I was speaking with, who she went to go visit her family in Canada at least once a month. And so needed a minimum of one Friday off a month. But didn't want to use up all her PTO doing that. So that was something important to her.

And she was able to negotiate that in addition to her paid time off. So that's really important. Non-compete is something that's an absolute must that you have to look at. So I've seen. Non-competes that are very fair. The most fair I've seen as you have. I don't remember how many miles it was. 10, 15 miles.

Non-compete for your first two years of employment. And after that, there's no, non-compete, I've seen non-competes that are absolutely outrageous 30 mile non-competes or, you know, something. It's closed systems here where I live have a non-compete that's 10, 20 miles from every single one of their locations.

And the locations span most of the big cities in the state and I'm in Texas. So that's a fairly large,

yeah.

Dr. Diana Mercado-Marmarosh: You almost have to move out of state or be ready for lawsuits. Right?

Dr. Lara Hochman: Exactly. And so even though it's technically not enforceable, the hospital can still come off to you and fight you for that many years.

Essentially enforcing the non-compete. So you really, really want to take a close look at that and keep in mind, you know, I don't love non-competes and I, I do see them essentially as a little bit of a bully tactic, but that's really when it's unfair. To either one of the parties from the practice standpoint, every practice I speak with is afraid that the person that they pick the doctor, they choose will open up shop next door.

So you really want to see it from both parties. What's fair. What's not fair. Is it, you know, five miles, 10 miles. Those tend to be more fair. Of course it depends where you are. Is it 30 miles. That's not fair. That's not fair at all. So, and sometimes what I'll see is candidates think, well, if I were to leave this job, then I'll probably just move back home.

But a lot can happen in a few years. You can, you can get married. You can. Get divorced, you know, so much can happen. That can tie you to a city. You can fall in love with the city and never want to leave. So if you have a non-compete, that's preventing you from working in your city, that's not. Okay. So, you know, take a very close look at the non-compete other great things to look at our benefits like health insurance. Dental vision, all of those things, but don't only look at what the practice is providing. Also take a look at what can you get on your own, because you may be able to actually get a job that pays great and pay, pay for your health insurance on your own, on the side, which is very expensive, but you don't want that to be the reason you don't take a job that you love.

You may, this job may pay. $1,500 a month more and your health insurance costs $1,500 and that may even be tax deductible actually. So, you know, there's, there's things you can do as far as that goes, be flexible and really think about it from all aspects as well. Other things to look at. So we have non-compete salary, the hospitals are able to usually, provide a higher salary because they're also making money off of the tests that you order, the referrals that you make. All of the other things that you're doing in addition to just seeing patients. So is salary the number one, absolutely most important thing. ' And you're Okay with taking whatever may come with that versus the you're OK with taking a little bit of a salary cut in a position that's better suited for you. And some people love hospital-based practices and they love academics because with that comes, research, it comes, you know, all sorts of really cool opportunities.

But for a lot of people who want to get in there and see patients and spend time with patients. Private practice may be a better, better fit for you. So take a look at all of those aspects and really think through what the caveat being like we said earlier, where you are now does not have to be where you are 40 years from now.

It would be wonderful. And that is what we all aspire to is to be in a job that we love and never need to change, but life happens and things.

Dr. Diana Mercado-Marmarosh: So curious, what do you think you're then it'd be up to in the next year or two? What are your goals? What are some fun things that you can't wait to get yourself or continue to do

Dr. Lara Hochman: My goals for this coming year? You know, I, I have a goal of I'd love to place at least two doctors a month. Business-wise this year is I just want to hear back from doctors about how I'm helping them, whether it's placing them in a job or maybe even something they learned from a podcast that I listened to. But that's one of my big goals is being able to make an impact, being able to spread the word that we don't need to settle.

We don't need to be unhappy and we're not trapped. That's something that I feel. A lot of us feel as retract and there's no way out and there's no way to go. So my hope for this year is to spread that message. You're not trapped. There are options. Fun things I'm doing. I have a trip planned in April to go to the EntreMD conference, that'll be super fun. Right?

 I get to see classmates and, Dr. Una who inspire me and who pushed me to do greater things every day. And I love watching everyone's progress and seeing what they're doing. I right now at the time of this recording, when the middle of the Omicron surge. So I took a break from exercise.

 I take gymnastics classes and not doing it is just killing me inside. So couldn't wait to get back to gymnastics. I'd love to be able to do a press handstand this year. It's been my goal every year for four years. So

Dr. Diana Mercado-Marmarosh: Are you getting closer?

Dr. Lara Hochman: Maybe this is the year. So this year I hope to really just thrive and, you know, become a better business woman, become a better parent and do that. Gosh, darn press handstand.

Dr. Diana Mercado-Marmarosh: I am so gonna root for you when this happens. And even while you're trying, because let's face it, it's who we're becoming right along the way, getting those goals met.

Right. So. Where can the listeners get in touch with you so they can learn about all the great stuff you're doing and maybe you could help change their life as well.

Dr. Lara Hochman: There's a few places you can find me. I'm on LinkedIn. My LinkedIn name is Laura Hochman MD. You're welcome friend me or connect with me and message me there.

You can go to my website. There's a contact form on there that you can reach out to me. It goes directly to me that is www. happydayhealth.co. It is not.com and I'm on Tik TOK and Instagram. My names, there are happydaymd

Dr. Diana Mercado-Marmarosh: Awesome! If you could leave us with one thing, what would be the take away point that you would want us to have?

Dr. Lara Hochman: I would say having ADHD does not need to be a liability. It does not need to get in the way. Who you are. Don't see it as a bad thing. It can absolutely be harnessed to be an asset. So use that and learn how to really harness your superpower. It can create great things, the best entrepreneurs. Art have ADHD because they're able to harness their creative thinking and their risk-taking abilities. And so it's a superpower. Use it.

Dr. Diana Mercado-Marmarosh: Thank you so much. That's such an amazing way of pointing that out. Now I have to ask because everybody's going to probably be like, oh my God, I love her accent. Tell me. Tell us where's this accent from,

Dr. Lara Hochman: I was born and raised in South Africa.

Dr. Diana Mercado-Marmarosh: Amazing, and now you said you're in Texas, huh?

Dr. Lara Hochman: Yee-huh!!!

Dr. Diana Mercado-Marmarosh: I am so glad to have you as my friend and as my classmate and everybody, please reach out to her. She as, you can see has your best interests at heart, and she can help you get placed in an environment that's going to help you thrive. So don't waste this opportunity. She might just change your life.

Dr. Lara Hochman: Yes. Please reach out. Don't ever hesitate at all. I'm here. I answer all of my emails, I answer all my messages and I would love to hear from you.

Dr. Diana Mercado-Marmarosh: Thank you again so much for sharing your wisdom with us today and your time. Because to me, time is the most valuable asset that we have. So I am so privileged that you shared that gift with me today.

Dr. Lara Hochman: Thank you for having me.

Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.

 

Guest Speaker:

Dr. Lara Hochman MD

Website: Happydayhealth.co.or https://larahochman.weebly.com/

Linked In: Lara Hochman,MD

Instagram: @happydaymd

Tiktok: @happydayMD