Episode 13 - Knowing Your Worth

Amanda Hil is one-of-a-kind - an amazing attorney whose mission in life is to support physicians to better advocate for themselves. 

This episode is a must-listen for any physician. 

Know your worth; know what you bring to the table; and be your best advocate.  

Connect with Amanda here-

https://www.hillhealthlaw.com/

https://www.guardmypractice.com/

Transcript

0:08

Welcome to the PurposefulMD Podcast. As a physician, you've sacrificed so much of your life for other people. Your patients, your family, your friends, and your colleagues. What would it feel like to spend time doing what you enjoy, and to live without guilt? I'm your host, Amy Adams. If you're a medical professional on a journey towards your most purposeful life, a life with more time and energy, and, ultimately, more joy, then this is the podcast for you.

Speaker: 0:44

Welcome to the purposeful MD podcast. I'm so excited to have this amazing guest today, Amanda Hill. She's an attorney in Texas. I've had the pleasure of meeting her in person and working with her and she's amazing. So we'll talk about how amazing she is. Yeah. So Amanda Hill is a healthcare attorney in Austin, Texas. She worked for the U S government defending large hospitals before becoming general counsel for several large groups. In 2015, she started her own law practice focusing exclusively on representing doctors. She has worked with physicians and healthcare management, her entire career providing guidance, training, and counsel. In 2022, Amanda launched Guard My Practice to try and prevent problems doctors were facing before they occurred and help educate physicians about the business side of medicine. And I know we'll be talking about that today. Amanda, so happy to have you.

Speaker 2: 1:35

Thank you. There's nothing I like more than talking to doctors. So, you know, my sweet spot.

Speaker: 1:40

Well, we appreciate you so much. And like I said, just so lucky to have met you and worked with you and learned from you several times. I've heard your story a number of times, and I know our listeners would love to hear it as well. So if you don't mind sharing your story

Speaker 2: 1:53

of how you got to where you are. Sure. Well, there's a lot of twists and turns like most people. It's not a linear path, but I started off at the VA. Um, right out of law school, not because I had some desire to work in healthcare. I wanted to be a federal judge, but because that was the only job I could find at the time. You know how this stuff goes, right? So that's where you fall into. And the first time, my very first case was, uh, an IV that infiltrated the arm and caused a lot of problems. And there was all this complications and I was hooked. Like the first case I had defending doctors, I thought this is my career and I never stopped. And so I left the VA. I went to private settings, non profit settings. My whole career was focused on doctors, and there's been some detours, right? I tried to leave a few times to do big creative things.. I was on TV, I wrote books, and then I finally decided I can do the best of both worlds. And so I started my own law firm, which was really liberating. And then I could pick and choose who I wanted to represent, right? I really loved representing doctors. I didn't want to do hospital administration. I didn't want to do the grind. I really wanted to help individual doctors. And that became my focus. And it's been extremely rewarding because what I've discovered is, you know, lawyers are like hated. With doctors like, Oh, they sue us. They're obnoxious. We hate lawyers, but yet there has to be some on the good side, right? You need some lawyers to defend you if you're a doctor. So I became that person and I've worn that mantle with pride. It's been really fun. And then in the middle of COVID, um, I realized that doctors were just breaking down and I didn't think it was really fair to the world to continue to just charge by the hour. To solve very basic problems, very basic questions that I was answering over and over and over and I thought, why is this stuff not being taught? Like, why aren't we training our doctors on how to negotiate and how to have difficult meetings and how to, you know, navigate employment issues at work? Like this is not rocket science and you don't need to pay me this much to solve these problems. So I, I turned a room in my house into a film studio and started making these training videos. Which training is kind of sounds pedantic, but you know, videos that I tried to encourage doctors to stay out of trouble, how to deal with these things, how to deal with complicated patient issues, how to find hope and humor again. And it's been really fun. And so that guard, my practice was born and all of a sudden I started creating courses. I was thrown into a completely different world of product, you know, sales, a whole different world than, than the law firm. So that's been really fun to sort of learn the difference between A services business, which is law practice and a products business, which is like selling a thing. So it's been a wild ride and I haven't looked back. I've just been going forward.

Speaker: 4:37

I love that so much. And, and I love your, your mission about helping physicians and how you said, I don't want them to continue to pay all this money. So just to answer some of these simple questions and, and just your heart. And how much, how much you care about physicians and how much you want them to succeed is just as beautiful. And, and I, I know our listeners and viewers can, can feel that from you and people. Oh,

Speaker 2: 5:02

thank you. I definitely feel that doctors are my mission field, which is a strange sentiment, but. You know, I've, I've almost died many times I had cancer. I, my heart stopped when my child was born. I got septic once and almost died. Lots of near death. I'm like me and death, you know, we're, we're tight, but I just try to make every day really purposeful as you do, you know, with a purposeful MD, but I just, I don't want all the knowledge that I've learned to just go rot in the ground. Like we have a duty to sort of share what we've been given and our talents and everything we know with the world. And yes, we have to make a living. Of course, you know, we, you know, we have worth and that sometimes equates to some financial, you know, ability to survive. But at the end of the day, it's very purposeful. I want to make sure to help doctors thrive because it's a hard world. I see all the problems that can occur. I'm on the other side where everything goes wrong with the doctor. So I have seen it all. And I want to just give some cautionary tales, you know, how to protect yourself, how to negotiate what's the secret sauce, you know, what's the, you know, wizard behind the curtain. And if I can help, you know, a small subset of doctors feel more powerful, negotiate with strength, you know, stay out of trouble, feel more confident, then our whole healthcare system is better as a result, right? It's like a trickle effect. And so I'm just doing my little tiny part to try to share this knowledge into the world and help with, with doctors that are struggling because our healthcare system relies on. The trained healthcare workforce to be strong. And if we're breaking down and everyone's burned out and fried, and I'm giving up on this, then who's going to be there at the end of the day, you know, who are we going to call? So I think that's why I'm so passionate about it. I've leaned on doctors a lot, you know, with my own health journey with my parents, you know, and you, there's such an important part of our social and, you know, emotional infrastructure. That we have to protect it. And so I feel like that's partly my job. I love that so

Speaker: 7:03

much. And, and you mentioned about feeling the sense of worth, and that's something that when I hear you talk, and when I read your, your posts on social media and hear from you is just that as physicians, we need to know our worth. And that's such a big part of what you do and how you help support physicians. And, and I, again, we would, we, I know we've talked about this before, but. We see physicians that sign contracts that either don't make sense or really just make the physician kind of this cog in a wheel and, and really don't help to support the physician to flourish and to be their best selves. And it's so, as a physician, we don't, like you said, we don't know, we're not taught these skills. We're taught to. Take care of patients. And we're taught that part of it, but we're not, we're not taught how to, how to even know what to look for in a contract or that we should have an attorney look at it, or maybe these are some red flags or what, what's kind of standard and what's not standard. And so I love that you're helping physicians at the, kind of at the front end, and I've heard you say this before, like, if you call me and you signed this contract already, then I. We may be able to get you out of it, but we may not. And here's what, what I would like for you to know before signing a contract.

Speaker 2: 8:26

Well, the thing I want doctors to know is that it's not, you know, negotiation doesn't start when you get a contract to look at that's, that's critical to convince the world is negotiation is a process, you know, establishing your leverage and telling people at your work, what you do well, and looking at it from the other person's perspective and sort of posturing yourself in a way. That doesn't just come the day you get your contract, you know, so if we can teach some of these skills throughout their career, they're going to be in better positions to negotiate. And, you know, I've had a doctor just yesterday who came to me and said, well, I'm officially the medical director and I have all these medical director duties, but I mean, they're not paying me anymore. So I kind of sheepishly went to them and said, you know, Hey guys, I, I really kind of think I should get paid for this. And they were like, yeah, we don't pay for those services. And she was like, Oh, okay. I'm like, what? You know, this is crazy. Of course you need to get paid, like honor yourself. You know, that's the thing. It's like, we have to look at ourselves and say, Do we provide value? I mean, do we have the knowledge and training to make this employer better or to make this entity greater and our skills have value? Of course they do. You know, so it's not in, you know, you shouldn't sheepishly ever raise your hand and sort of ask kindly if they would mind paying you for the services that you're providing. And so that starts early, you know, it starts with, you know, being vocal about what you actually do to help the organization. And pointing out the things that you've done to build or grow this entity, show them that you are an inseparable part of this team. Because oftentimes physicians like to hide and they put their blinders on, they do their job and they go home and they just don't think about being their own PR advocate, you know, but that's part of negotiating you. You want them to see you as an integral part of the team. And if they lost you, things might fall apart. And so that gives you leverage. And I talk about leverage a lot with doctors because I don't think they know how to find it. You know, I teach a course. We were talking about this earlier with Dr. Vertrees. It's called 90 day notice. And it's all about doctors changing jobs because this transition is really hard. And one of the things we do in that course is we try to find leverage. I'm like, okay. And I put, here's a fictitious doctor. I made up all these facts about her. Let's pull from that. And what we think is her greatest leverage. And they just look at me like deer in the headlights. Like, I mean, she's, she's a surgeon. I don't know. Like they want to repeat the training. What, you know, she's good at this. She went to this school. I'm like, nah, that doesn't have anything to do with it. Leverage is really why you're so invaluable. Right? What makes you different and sets you apart and makes the other person say, Oh my gosh, we, this is the exact person that we need for this job. And it can be anything. You know, it could be that you're amazing at the EMR, you're bilingual, you have great people skills and you have the ability to draw people together. Those aren't really related necessarily to your operating skills. It's stuff that really adds to who you are. So I love talking about that because. You know, it's trainable and it's teachable and doctors can make remarkable strides in negotiating. If they can think about this all the time, not just when they get their contract, because honestly, when I get the contract, I pick my battles and try to pick two to three things. You know, there may be big ticket items that we're going to negotiate. We're not going to bleed all over it and, you know, and try to destroy a contract. So, but if you have that leverage, you're going to get so much farther. And so that is where I love that you're coaching me. Because coaching is really important in helping doctors see their own worth. And that's important for me to talk about as well. You know, it's like you have this, this worth that you don't even realize. You know, let's help you find it because then you can communicate it to the other side or in a contract negotiation or even just in a workplace, you know, a lot of times doctors, like, I just don't feel like they value me. I'm like, have you let them know what you're doing for the organization that maybe is going unseen? You know, maybe they don't know that they need to value you. So I think that's a huge part of it is just encouraging doctors. And I. I hate to be gender focused, but I mean, women are not as good sometimes about standing up for themselves. You know, we're such caretakers, we're mothers. We do things for people without really expecting anything in return or noticing it. And that has to change in the workplace. You know, yeah, your, your 10 year old's not going to say thank you for making their lunches every day. That's fine. But at work, you know, you need to make sure that you are, you know, your own best advocate. That's really important.

Speaker: 12:55

Yeah. I love that so much. And I hear that from my coaching clients and I do hear it a lot. I mean, I. I probably coach more women than men, but I do hear it a lot from women is that the sense of, well, I'm replaceable or I'm dispensable, or they'll just hire somebody else. They don't really need me and helping them to realize how much they are truly worth. And that. What they do bring to the table. And it could be a, I mean, we can talk about, let's bring it down to the dollars. So you have a large patient panel and those patients might leave if you leave. And so that could be leveraged too. And so I just, I love that, that you really help physicians to find their voice and to advocate for themselves. Cause that's not something that we are trained to do either. We're, we're trained very much to downplay our, you know, Any positive attributes or downplay our accomplishments because we're just there to, to get the job done. And, you know, in medical school, you know, look to your left and look to your right. And one of you is not going to be here in four years. It's like, okay, that's, this is just the first day.

Speaker 2: 14:02

Thanks so much. And that scarcity model affects you for the rest of your career, right? Cause then you're like, Oh, I better not rock the boat. I'm not going to have a job. You know, there's so much fear of my clients calling me saying, I'm afraid. I'm afraid if I push too hard on this contract, they'll rescind the job. I'm afraid if I mention something, I'm going to get retaliated against. I'm afraid if I report this issue, it's going to come back and hurt me. It's like, Wow. You know, there's a lot of that. And luckily there's people like therapists, coaches, attorneys that have safe, they're safe, you know, that in my case, privilege. So I, no one can, you know, know what we talk about, but I mean, even with my, with, I have a lot of male clients as well. And a lot of their issue is money. I want this money and some things I have to talk about. It's not all about money. You know, let's talk about your schedule. Let's talk about your time. I mean, they don't think about that as much because their worth is. I need this salary to feel important or to feel like I'm providing. And then they forget that, you know, they're sharing call with three people, which means they're on call every fourth day. And all of a sudden they don't, they're never at home and they're get divorced. And, you know, it's like, it's skyrocket. So part of my job is just to think creatively, you know, what is sometimes my clients are surprised sometimes when I sit down, I'm like, what are you actually wanting? What are you looking for? You know, what does your future look like? So how can I negotiate for you unless I really know your inner goals? You know, do you want to spend time more with your family? Do you need more admin time? What's a struggle for you at work? Because let's create a job and a structure and a comp model that actually, it fits your personality instead of just going for more RVUs, more RVUs, and you're killing yourself. And so I think that's important to look at it, you know, as a holistic way. Instead of just being like, you got more money. And then another thing I say is like, wait a minute, you can put money in different buckets. Like your salary can be X, but then it can be lower, but then you have supervisory pay and a bonus and you know, this other thing and this other thing, and you add it all up and it's fine, but yet you've creatively structured it to fit your life better. And so, you know, that's something I love to talk to doctors about is just how can we find the solution that works best for you? And, but often though, doctors that call me are in crisis. You know, they've gotten themselves into a jam, they've gotten fired. And trust me, I never, ever saw doctors get fired 20 years ago. I mean, they did, they were like sexually harassing the nurse, you know, or they like slept with a patient or, you know, taking cocaine or something, you know, it was something major that you were like, okay, they got fired. Now, doctors are being let go all the time without cause, without reason. The contract's not renewed. You didn't make us enough money. We're going to replace you. It's like very, it seems very replaceable. And that starts to affect the psyche of physicians. You know, it's like, I really am just a cog in this wheel. I could just be let go. They can just terminate me with 90 days notice and then I got to find another job. It's like, how can this be? And so a lot of that is, you know, You know, helping him understand that this is not the end. Doctors can change jobs. You will find something new. There's hope. And many times, overwhelmingly, whoever listens to this and is like, that's not my situation, mine is hopeless. I disagree. There's no situation that's hopeless. You're going to find something else and look back and say, I learned a lot of lessons from that and I'm really glad that I found this other thing. And a lot of times it's better. Most of the time it's better. Because you know, you only grow with bad experiences. And so, you know, I often tell my children, you know, don't be, don't, don't be, Don't think that you need good things your whole life. Like only way we learn is through struggle and pain and failure and having a bad boss and a bad job. All these are learning lessons and you will come out stronger. You know, but you also need tools, you know, through coaching, through therapy to root out some stuff and get a good lawyer and get help and have a team around you. And I think the short sighted part is when doctors like, Oh, I can't afford any of that. And then they just curl up in a ball and they think they can handle it all themselves. And that is impossible. We have to have a team. You know, we're very community driven, you know, humanity. And so I think it takes other people to help, you know, with everyone's resources. So I'm really, I mean, I have that mindset. I think it works because I've been through those hard things and it's taken, you know, people to help get you out of them. So hopefully, you know, we'll develop a society in the future that relies on each other.

Speaker: 18:24

Yeah, it's a, it takes a village and that's another mentality of physicians is this notion of I, I just, I suck it up. I can figure it out myself. I can take it. And I hear that a lot from physicians who are afraid of changing jobs that they fear that, well, does this mean that I've given up or that I can't take it or I can't handle I can't handle the heat. So I had to get out of the kitchen. Or does this say something about me and my ability to handle stress and, and that it's, it's heartbreaking and it kind of goes back to

Speaker 2: 18:56

Is when let's say an office manager starts bad mouthing, you know, the oncologist or the surgeon and all of a sudden you're like, so that person is spreading rumors about me and everything I've ever worked for is going in the toilet because someone's trashing me and I can't do anything about it. You know, it's so powerless. I think that's probably the worst human feeling. Besides loneliness is just feeling absolutely powerless to change it, you know, and you feel like you feel like your stomach is dropping, you know, I, how, how come people can talk this stuff about how come they can say this? How come they can just fire me? You know, I feel like I'm sinking and that is very closely tied to clinical depression. And, you know, especially men, not always, but. But who usually the doctor is often the primary breadwinner. And so they feel like they're letting down their family. They're failing everyone, you know, they're letting down their parents. I mean, it just gets aggrandized to the point where it's a catastrophe. And you know, It's so hard to say, you know, the office manager that trash talk to you doesn't get to determine who you are. You know, they do not determine your worth and you're only looking for one more job ahead, you know, and it's so important to walk through that 90, that whatever notice period or that transition between jobs and try to do your best during that. I call it the lame duck session between jobs to hold your head high. To really continue to, you know, not burn that bridge and to try to move forward. And there's a lot of techniques and strategies to that, you know, but it's so tempting to want to light people up. And I've had many clients I've talked off the ledge because they are about to fire off the emails. And I'm like, what does that serve you? You know, it just, it doesn't, it doesn't really help you in the longterm. It just makes you look really defensive and angry. And that's not really a good look. And that's what they remember. They don't remember your 10 year career and all the people that you helped and all the loyal children that you served as a pediatric oncologist. All they see is this angry, toxic exit. And so that's a really big, That's, that's a growth point, I think, to be able to say, okay, I trust you on this. I'm going to try to exit with my head held high and to try to do it the right way. Um, because I've seen, and I've seen doctors that did that against every grain that they had, and then all of a sudden the group is like, Why are we letting them go? They're so wonderful. You know, and they actually asked them to stay and the doctor was like, no, thanks. You know, I'd really rather kill you, but it's a complicated world. And oftentimes it has nothing to do with the doctor. It has a lot to do with finances and money. And, you know, it's the world we live in. So unless you run your own company, you know, and you have control, then you are under the wing of someone else. Yeah. And that's unfortunate.

Speaker: 21:49

Yeah. I mean, having just been through the transition and feeling, you know, feeling this kind of sense of feeling like a lame duck and starting to see other people take on responsibilities and tasks that I was doing. It's a weird dynamic and I'm not the type of person that is going to, you know, fire off angry emails. That's not, that's not me. And I don't have a reason to do that anyway, but it is a very odd, you know, situation. Period of time to be in. So to have the support, I mean, I have, I still have multiple coaches and have supportive people around me and, you know, you and other friends and the eMERGE community and other, other people that I can lean on is that's a, it makes a big difference. It makes a big difference.

Speaker 2: 22:30

Well, I always say I feel more comfortable around doctors than I do my own kind, which is lawyers. Because when I go to a lawyer conference, you know, everyone is just You know, so competitive and, you know, they also don't want to show weakness. They never want to admit they don't know the answer to something. And, you know, they're always sort of an expert and they don't want to answer questions. It's just, so can be a little toxic in that world, at least with doctors. Um, you know, when I come in, they're just so open and there's a lot more emotional connection, you know, between myself and female physicians, which is why like, that's my people, but it's also really empowering, you know, to, as you get older, You know, I've been practicing law for 23 years and there's a lot of stuff. I don't know. I was just talking to a doctor this morning and I was like, I don't really know how you're going to set that pharmacy, you know, via, you know, versus the DME company and interwoven and in your management. I mean, that's complex and I'm not sure how we're going to do it. And I'm gonna have to think it through, you know, to be able to admit, you don't know things just in the world, in your world as well. You know, I don't. Exactly. No, what's wrong with you? This doesn't fit the mold. I've done the differential diagnosis. It doesn't seem to work. I don't know yet. We're going to keep exploring, you know, and I think that mindset transcends professions. You know, it's just staying curious and admitting you don't know things. And that's the only way we grow. Is it for like, you know what? I don't know. I'm going to look into that. That's a really good question. You know, and I think that as, when I now go to conferences with other lawyers, I'm like, bless your heart. Everyone's trying to posture, you know, everybody's trying to act like they know everything when that's just not the case. We cannot carry GPT in our head. You know, we're only human. And so I think that giving the permission to other professionals to be like, it's okay that you don't know how to negotiate. It's okay. You weren't trained at that. You know, I have a doctor that said to me once, I have read this paragraph. He's like, I'm not exaggerating. I've read this paragraph four times. It's English words, but I do not understand for the life of me, what it even says. Like, it doesn't even make sense. The words don't make sense. And I'm like, I know. And then I could explain it. In five seconds. And he's like, Oh, that's what it says. Oh, okay. Well, that's fine. Because that's what I'm trained in and he's not. So that's, I think what we need to know is like, everybody's got their thing that they do really well, you know? And that's why, you know, I go to a lot of other people for help. When I need it that they're good at. I mean, I can't read an EKG. I don't know how to what my colon looks like somebody else does, you know, so it's really fun to have a community of people that are smart, talented. Support each other. You know, you can call, you know, at a moment's notice. And I found, especially with this course that we're teaching that that community is everything, you know, I mean, doctors will call me later and be like, in fact, I gave a speech in Houston a while back and a client brought a gift, which has never happened, you know, which hardly ever happens. Usually they just pay me and that's fine. But she brought me a gift and she was like, I was, I thought I would never get out of this deal and I was so stuck and now I feel so free. You know, and, and it was sweet, like wrapped. It was a bow. It was like, that's so sweet. But you know, that's, to me, that's a calling, you know, when you feel like you can get someone through a situation that they never thought they could get out of. And now all of a sudden they're out of it. And they're like, wow, you know, I'm, I'm free from the chains and that feels good. So hopefully we can help each other with that.

Speaker: 25:52

Oh, that's, that's so amazing. And you asked a question earlier that when you start working with physicians, even before the contract phase, when you sit down and you ask them, what is it that you want? Because as a coach, I asked that for my clients too. What is it that you really want for your life? And I find that a lot of people have not asked themselves that question and they've been too busy. Right.

Speaker 2: 26:15

They've been training. They've been working. They've been taking tests. Yes. Going to residency. They, they got the job. They're having the babies. Like, it's like, they never stopped to think about it, you know, and that's exactly the reason that's funny. You mentioned that because when I was, I, one day I sat down, it was the middle of COVID, you know, everybody was frustrated. And I sat down with my husband. I was like, I, something's missing. You know, I just don't feel like I have the passion anymore. And he said to me, what is your favorite part? Of your job. What brings you joy? What about all the parts that you like the best? And I was like, that's, I never sat down to really think about it, you know? And then I was like, I like talking to doctors. I like explaining, I like helping solve problems. And he was like, well, then that's what you need to focus your energy on. And I was like, Oh, and just the thought process of, Oh, What is it that you want to spend your time on? What is a priority for you? How do you maximize that? And it does take strategy. I mean, one thing I talked to doctors about before you go blast off a notice and fire, you know, go quit your job. And it's like, do you have a strategy? Have you actually thought through what that looks like? Because the minute you tell them that you're leaving, everything changes. So have you taken your PTO, your CME, have you thought through what that looks like? What about your future? What if they send you home tomorrow? What about your patients? You know, what is the plan? And I, that's the strategy part is just as important, you know, and you need to have the time and mental space to say, what's important to you, what do you want and what is this going to look like? Imagine yourself going through this process and all the things that hit you. You know, a lot of doctors. Have put in their notice. And then they send me their contract. I go, can we, you just read this and just tell me what it says. And I'm like, you didn't think to do that before he quit, you know? And so I will say, well, did you know that you have to pay back your sign on bonus, you know, and now you're responsible for paying for tail, if you would've just stayed an extra four months. You know, you wouldn't have had to pay that back, but they didn't strategize. I didn't think that through. So it's really important to really sit down over a weekend, you know, and just clear your head and think about the process. And I think that'll get you really far. Yeah.

Speaker: 28:22

Yeah. Well, I have to ask you, because of course all the talk is about non competes now as we're recording this at the FTC. As band non competes. I know that's a, there are a lot of nuances to that. So tell, what is your understanding of that and what is your advice to physicians?

Speaker 2: 28:40

Well, it was funny. I was in Houston at the time I was over at Houston Methodist. I, I saw the ruling come in and my phone literally blew up. Like it was like, all my clients were just like, what does that mean? We're yay. Hooray. I'm breaking open champagne. They were so excited. And I was like, hold on. So I wrote an article literally that night in my hotel room for medical economics, because I wanted to get a jump on it. I re I like opened up the 570 page document. I mean, it was like such a long night and the, my take on it is. It is being legally challenged. Okay. So we all need to be aware of that. So they issued the preliminary ruling back in January, and then they tweaked it some after 27, 000 comments, which kind of broke the internet, but there you go. And then they issued this new ruling and You know, do, did they overreach? I mean, as a lawyer, I personally think they did a little bit. Now I want non competes to be banned just like everybody. I mean, most of my clients don't want to not compete. So it's not that I'm against this ban. I think it's good that we can eliminate non competes and doctors can work in their communities again. But I do think there are some legal issues. issues to this. I mean, it's a five person panel, you know, the FTC, three Democrats, two Republicans and five people in a, you know, in the FTC commission up in DC has now wiped out. All non compete state laws in the nation. I mean, that is a bit of an overreach in my opinion. So I think the U. S. Chamber of Commerce lawsuit that was just filed had some pretty darn good arguments. I read it thoroughly. Um, and you know, we'll have a ruling this summer, so we'll see whether it's enjoined or whether it's stayed. Otherwise it will go into effect once it gets in the Texas Register, which has not happened yet. So I think there's just a lot of influx on whether or not it's going to hold. If it does hold, yes, it will change every, you know, there's majority of states have non competes. There's only four that don't. So it will change massive amounts of state laws and, you know, lots of joyous doctors will be happy to, you know, even if it's existing on the books. Now, there are some exceptions. Even if it does go into effect, right? If, if you're buying or selling a practice that you can still have a non compete, if you're considered like a senior level executive that has policymaking power and you make over 151, 000, you know that, but what does that mean? I mean, again, there's just so much vagueness to this. It's like, if you're a medical director, do you influence policy? I don't know. It depends. Let's do an analysis. And if you're a nonprofit, of course, which most hospitals are, it doesn't even apply to nonprofit entities. So there's a lot that remains to be seen. I will say though, because I got like blasted for being so negative about it, they were like, do you not care? I'm like, look, I do care and I want this to go into effect, but I think what we should focus on Is just more state level advocacy. Like, we need to convince our states, these doctors are leaving the state. They do not want non competes. It's not fair to make them go over 50 miles from their home just because they changed jobs. No other, you know, especially with doctors. It's so important, you know, physician patient relationships. So, I mean, if we can just maybe use this as an impetus for local advocacy, even. You know, hooray. That's what I'm doing with it. I'm trying to convince people locally. They're like, Hey, let's use this as a spurring for change. But you know, I don't know. I think it was a bit of an overreach and we'll see what happens. Yeah. Yeah. It'll be interesting. Yeah. I know doctors are really excited about it though. It's like happiness.

Speaker: 31:55

Yeah. Yeah, definitely. Tell us about the course. So you and Dr. Amy Vertrees, who's amazing. And I've had her on the podcast before and, um, and she's a surgeon and a coach and just an amazing human. Tell us about guard my practice and what you guys are doing and 90 day course and all of this. So

Speaker 2: 32:16

this course did, I didn't start teaching this course. You know, I started with just like, I'm going to teach a course on contracts and I'm going to teach a course on how to stay out of trouble and all this, but guess what we kept hearing. I know I kept hearing and Amy did as a, as a surgeon and coach. Is doctors were losing jobs, doctors, you know, frustrated. I didn't know how to get their next job. And, you know, and they couched it and I don't know how to negotiate my contract, but really the inside of it was. I feel totally overwhelmed. I don't know. You know, you're not taught to quit. We aren't quitters. Lawyers and doctors are not quitters. We win.

Speaker 3: 32:47

We don't know how

Speaker 2: 32:48

to get fired. And so it is a devastating thing. And we, we heard more of that than anything. It's just, you know, yes, I need help with my contract, but mostly it's, I don't know what to do. I'm so flooded. You know, I've got my current job. I'm, I'm devastated. I have emotions. I have a lot of negative energy here. And then now I've got to go find something else. I'm wondering if there isn't something posted. I've got this non compete, my family's relying on me. It's like, it's too much. And so we created this course sort of out of that need. Of how do we help doctors from one job to the next? How do we help with that transition period? And so we sort of did it on a whim once, you know, and it worked so well that we just kept doing it. And now we've taught the course now three times and we finally converting it. We're launching it soon into an online program, which is a lot more accessible because doctor can join at any time. But we have, we've really have a lot of modules prepared. That we've sort of structured based on what we hear is the most helpful. Like we, I really want to teach a doctor to look at their current contract and to see what to look for. And then we step back and we think about, like you said, what do you want? What's the wheel of life? What's missing? What are you looking for? And then we think about an ideal job that is better for them. You know, what is the right type of job for you? Then we go into leverage, which is my favorite topic. I love talking about leverage, how to build it, how to find it. And then of course, my contracts are like my jam. So we talk about contracts a lot. We have a lot of stuff on contracts and how to negotiate what to look for. And then at the end, we talk about things like how to let go. So you don't repeat the same mistakes, you know, how to deal with the exit interview or even the actual interview, you know, how to deal with a lot of these negative emotions and how to let them go before you keep repeating it. So I think it's a really, it's been a really. Fascinating journey to see these doctors go through it, you know, and one doctor, I think that one of the, the comments the doctor made was, I knew I had this stuff inside of me, but I couldn't put the words to it. So now I feel like I can better articulate my worth, you know, and I feel much more confident going into a new job. I just feel like a totally different person. I was like, Yes, we did it, you know, so, and then Amy's got the, you know, she's a coach, so she does a lot of the mindset work and I'm the lawyer, so I do a lot of the contract negotiation stuff. So together it's really beautiful and she's really great to work with, but it's just such a good synergy and I'm really glad we partnered together for that because I think it's going to change a lot of doctors lives.

Speaker: 35:09

Yeah. And it's going to change. It's going to have a ripple effect, you know, as other doctors start standing up and advocating for themselves, then it just becomes the norm where now it's not the norm and we need it to be the norm.

Speaker 2: 35:22

Yes. You know, it's funny. I'm changing subjects. It just popped in my mind. My daughter gave her senior thesis on changing about food insecurity and changing the food stamp program and adding more stuff, you know, Training grants for trade, you know, education and nutrition and all this stuff. And a lot of the question and answer, it was kind of like a senior thesis where I could have to defend it in front of experts. And they said, you're not going to change behavior. You know, people that are in this program are going to never change. And she said, you have to look at the generation below them and we have to educate the next generation. So they don't repeat those mistakes. And I'm like, I'm learning, you know, that was a great answer. You know, it's like, that's what we're doing. We're training the new residents. The new graduates and my other passion with guard, my practice. I'm so glad that this is happening. I have a pilot program, which I don't want to announce yet because I haven't signed the contract. It's happening this week with a massive institution. And I'm going to be putting my guard, my practice videos and their residency program, which is huge. And I'm so excited because I want to keep replicating this throughout all the States. We have to train our residents, you know, better in this regard. And so I've made basically. 50 videos total. And I have picked and choose the ones that I think would be more suited to residents. And, and we are going to change the way doctors. think of themselves the way they negotiate and we're going to better protect our new doctors. We owe it to them, you know, so they don't go floundering around and have to hire lawyers. You know, it's like, I mean, we have a purpose, trust me, my law firm is busy, but it should be reserved for something that you really need a lawyer for, you know, not the basic, you know, You know, training to know how to look at a contract or how to, you know, not fall into a fraud and abuse situation because you just had no idea how to spot a red flag. We've got to train that a lot better. And, you know, and so that's my goal is not only to help the current doctors that are in transition, but the new doctors, you know, that are coming out first year, To say, you know, they're, they're ready and they're not going to accept, you know, anything less than they're worth and they're going to negotiate better. And the non competes are, you know, going to fall away because we're going to fight them harder. And so, yeah, I have a heart for that. And the more we can get into those residency programs, the better.

Speaker: 37:33

Yeah. And I, that's just, it's really creating that tipping point and creating this groundswell of people that are not going to put up with crazy stuff in their contract and, and things that don't make sense and ask themselves first, what is it that I really want in this job? And I love how you frame what you and Amy are doing with the 90 day notice is that you, it's like, you're talking about, what do you want to move? Towards rather than what do you want to move away from? That's how I hear it. And just framing that up in that way is, is just so impactful. And I love that mission.

Speaker 2: 38:09

Well, victimhood is sort of those quicksand of life. I always say, you know, it's like, Once you fall in that pit, you cannot get out. And when I have doctors that are just, this happened to me and this happened to me, and you don't understand, this is very unfair. And then it's just, it's victimhood, victimhood. And you've got to turn, you know, forcefully turn away from that because it's so easy to fall into. All of us have been a victim of something, you know, whether it's our childhood trauma or whether it's, you know, a horrible toxic work environment, whatever it is. And there's a lot of stuff that happens that is absolutely not fair. And I admit it, it's not fair. You know, I am a white You know, blonde woman, I don't know the struggles, you know, of a lot of my dark skinned African American Indian clients that are so much that they have to face that I don't have to face, you know, there's a lot of things that can turn you into that sort of bitter person. But the strongest people that I know are able to turn away from that and say, I'm not going to be a victim of my circumstances. I will look forward and find a way to pull people up behind me. To look forward to the future, to not look back and say, this is the defining moment of my life. You know, it doesn't have to be. And I mean, I, I, I always say I had a doctor that was doing drugs in surgery. Okay. Because he was an addict and he came clean and he, I said, if you, if that guy can survive, you will survive, you know? And it's just like, there's nothing that you can't really get over. I mean, there are low points in your life. I've seen a lot of them and I've seen a lot of doctors crying and sobbing and, you know, how am I going? I don't know. I don't want to go to jail. I mean, their whole livelihood is, is affected. Yeah. And those are hard moments. And I always say, it's going to be expensive and it's going to be time consuming, but we'll figure out a way to get you out of it. It's just money. You know, part of the, the, what doctors are so devastated about is like, they lost 50, 000. I'm like, because of a bad investment. I'm like, okay, well that sucks, but you can always earn money. You know, it is not the death of you to lose some money and it's just a lesson and you move forward and you can't get stuck in it. So yeah, I think that's the biggest pitfall is that people get in. And if you can just look forward and look past it and kind of have hope, then you won't get stuck in that pit.

Speaker: 40:19

Yeah. And just having somebody like you that is going to sit there with you and say, we're going to get through that is amazing. So helpful.

Speaker 2: 40:28

Well, every once in a while I say the words, I'm going to refer you to my friend who's a criminal defense lawyer and that is not what they want to hear. And so, you know, it is what it is, but that's why it's important to work on these things in advance. You know, when I go train new residents, I always say, let me give you the top three or four things you need to look for in a sham deal. You know, let me create this. You know, inner compass, if you, you know, cause you don't sometimes have it. I mean, you know, it's not like it looks like right versus wrong. I always say there's not vendors with like a trench coat. They're like bought a boom. You want a son deal? You know, they're not, they don't look like criminals. Right. These are easy to fall into. These scams are truly professional scam artists. And so, but some things I do is like, okay, these are what I'm seeing. And so really be careful when you're signing this kind of deal or contract or thing with a lab or make sure that. You know, to me, that's my passion is just to be like issue spot. Okay. That's half the battle because before you sign this deal, just think, wait a minute, these they're really wanting my patients. What's the ulterior motive for why they want me. They really just want my MPI number. You know, they just want me to sign this so they can check a box and they can make money. And if you can just start thinking that way, it's like, what is they, what are they really after? Then you're going to automatically be better off and probably get those reviewed. And the lawyer can be like, you know, many times I've said, Oh my gosh, do not sign this. Wait, this is a scam. This will get you in trouble. And you're like, I had no idea. Glad I asked. And that was like half an hour of my time that saved them years of headaches. So it's definitely important to issue spot better. And I think we can train that. Yeah. And

Speaker: 42:02

then it sounds like that's, that's where, you know, that's where your passion lies and what you're going to be doing with these residency programs. I love it.

Speaker 2: 42:09

Well, and it's also fun to talk about pay. I mean, you know, we sometimes get so locked into patient, you know, regulations and healthcare fraud and negotiating contracts that what about the patients? You know, what about the doctors that call me and say, I cannot believe that my patient felt a board complaint against me. How could they, you know, it's devastating. Or, you know, I can't see, you know, this patient is so angry because their tummy tuck failed and they want to sue me and they want to put me all over social media. One doctor, we settled a small case and he said, can I put extortion on the memo line? You know, he was laughing and it was a joke and I, you know, but this is hard stuff when you have discord with your own patients. And so some that what we talk about is, you know, how to build these relationships with patients better and how to deal with it when you feel like they turn on you and how to, you know, Sort of walk through that and get out of that and not hold it forever because you know, I have had the most qualified surgeons. I had a surgeon in Arizona who's like one of the world renowned cardiac surgeons call me pissed off. He was for 30 minutes. He ranted about a board complaint that some patient filed against him. Why are you letting this person drag you down and take up all of your mental space because of some dumb board complaint that they thought was like a Yelp review? You know, but they're just, they click the button and they filed this complaint against you. Do not let it eat you up, but it does. And it's human nature because you don't want people. That don't like you, you know, or that write bad things about you. And you feel like your reputation's harmed and that's hard. So they need someone to call, you know, they need someone to talk to about it. And so I can be the phone, even though, yeah, they pay it by the hour, which sucks, but you know, they have someone to talk to you about it. They can say, I know I've been through this a lot. I can see how that would be hard. Yeah.

Speaker: 43:51

Well, where can, where can people find you if our physicians listening want to work with you, where can they find you?

Speaker 2: 43:56

Well, if you're in Texas, you can hire me as a lawyer and that's Hill health law. And we just redid our website so you can see all of my new lawyers. It's fun. And then a garden, my practice otherwise is my, my video platform. And we have a lot of courses. We are about to launch the 90 day notice online course. So if you're interested, send me an email and I'll put you on like the VIP wait list for that. So when we launch, you'll be the first to know. But yeah, guard my practice. com and then find me on LinkedIn. I've been posting a bunch on LinkedIn. I love LinkedIn. I think it's like kind of where a lot of doctors live and talk about hard things, professional things. It's not quite a social, which I really love it. So all those places. Yeah. And we'll include those links

Speaker: 44:34

in the show notes as well. So so much for inviting me. This is awesome. So wonderful to talk to you always. And thank you for being here. You're welcome.

44:46

Thank you for listening to The Purposeful MD Podcast. If you like what you hear, please rate and review the show. Please also visit my website, www. thepurposefulmd. com for free downloads or to discuss working with me as your coach.