Business.
Greg winteregg, dds - questions to answer before adding an associate - this is" part ii" of a two - part article on the subject of dental associates. (part i is available at: http: //www. gregwinteregg. com) perhaps now or some time in the future, you' ll think about adding an associate. Part one of this article offered guidelines to help determine the need for an associate in your practice.
Whether that time is today or ten years from now, it is best to be informed on the subject. - in this article, we' ll pick up with questions you should ask once the decision is made to hire an associate. What type of work do you expect the associate to do - i. e. what would be his or her job description? Specifically: Do you want an associate or a partner? How should you pay an associate? How does the associate' s treatment philosophy match up with yours? How do you find the right associate?
How can you tell if the associate" fits in" with your office, staff and patients. - the associate starts with the idea he or she will be offered a partnership and eventually buy the owner/ doctor out. Let' s start with the first one: "Do you want an associate or partner? " You should never enter a relationship saying" Well - come on board and we' ll see how it goes and work out the details later. " If agreements are not clearly delineated, each party has their own" idea" of what the agreement is and they seldom match! The owner/ doctor is entertaining the thought but is ambivalent. The associate feels abused and taken advantage of and decides to leave. The associate makes the schedule easier so the owner/ doctor, who originally planned on retiring in three to five years, has more time off, and decides to, feels better work another fifteen years. The owner/ doctor finds himself back at square one.
In this case the doctor failed on both the communication and leadership fronts. - what happened? Had good communication existed from the get go, with a clear reality of where the relationship was headed, things might have turned out different. If partnership is a possibility though, at least have some benchmarks in place and get these agreed upon by both parties beforehand - and stick to the agreement. You don' t have to offer a partnership right up front. For example, you both agree that you will work together for a set evaluation period before talking partnership, etc. If the associate met certain guidelines and the relationship was good, he could buy in.
One excellent example I saw was a doctor who had his new associate( potential partner) sign three agreements: a) associate, b) buy - in and c) buy - out. - if the owner then wanted to sell the remainder the associate could buy him out, etc. This should also be made clear. Either way - you might not want a partner - ever. Talk it over with your accountant or other advisors and decide what you are shopping for before you start on this journey. Will they treatment plan and present their own cases?
The next question is: "What type of work do you expect the associate to do - i. e. what would be his or her job description? " Do you expect them to take all operative and root canals off your schedule and see all the children that come in? - determine issues like this prior to interviewing, much less hiring. They either fit or they don' t. Keep in mind that the associate is there for you and your office. Imagine you were selling your house. The realtor would find another buyer. If the realtor brought in a potential buyer that asked you to add a pool and two more bedrooms, you wouldn' t do that to make it work.
Same concept with an associate. - the prospect you are interviewing refuses to do root canals and doesn' t really like kids. For example: You want an associate to free up your schedule by taking all of the fillings, kids and root canals. Next... You get the idea. If you needed a full time receptionist and you interview someone who can' t work Mondays and Wednesdays - why hire them? While some things are of course open to negotiation - don' t go crazy attempting to accommodate. You eventually will find someone who can.
If they are to find their own new patients, present their own cases, etc. the percentage would be higher. - the third question is" what should you pay an associate? " this depends on what you expect the associate to do. Conversely, if you handle all of the treatment planning and fill their schedule for them, the percentage would be lower. If you had an associate producing X amount at Y percentage - what would that equate to and how would that impact your bottom line? Sit down and do the math. Also consider how this would impact your schedule.
For a GP associate, anything over 35% of collections in compensation is too high in my opinion( specialists are an exception) . - if you are booked out for several weeks and you give an associate all of the operative, single unit crowns, root canals, etc. you would be able to move all of the major work on your schedule forward making you more productive. I' ve seen some doctors who pay their associates 25% if all they do is work on patients with no treatment planning responsibilities. If you are going to do this, you have to ensure it is viable for the office. You can also mix a per diem and percentage. For example: You guarantee a doctor$ 450 per day.
You decide you don' t want to exceed, let' s say, 30% in compensation for the associate. - he works 16 days per month, making the guaranteed salary$ 7, 200 per month. So we take that$ 7, 200 and divide it by 30 and multiply by 10We do this to determine what$ 7, 200 is 30% of. On the other side of this, what happens if this associate who you are paying$ 7, 200 a month and, their average collections, after ramping up are only$ 15, 000? Here' s how the example works out: Associate Monthly Base= $7, 200. $7, 200 Divided by 30 equals 24 240 multiplied by 100 equals$ 24, 00$ 7, 200 is 30% of$ 24, 00 So, if we are going to give a percentage on top of the base, we tell the associate that they get 30% of anything they collect over$ 24, 000 in a given month and distribute that amount at the end of the month. In that case, you had better do something as they are costing you more than they are worth - in this case 48% !
They won' t be making enough money and below that level of production you aren' t making enough of a profit to keep them around. - in my experience, if an associate can' t do$ 40, 000 per month, no one is going to be happy. You must have enough business to make it worth everyone' s while and they must be confident enough clinically to produce it. If no prospects are immediately to hand, you need to go out and find someone. The next question is: "How do you find the right associate? " You' ve filled in the blanks and decided what you want and what you have to offer. The question is: where to look? Here are some ideas: Advertise in the paper.
The answer: Everywhere! - ask various sales reps( i. e. your supplier, etc. ) call your friends and colleagues. Advertise online. Advertise in local and state dental journals and newsletters. Have your office manager help you contact doctors in your immediate area to see if they know anyone. Contact residency programs in your state. Sign up for an associate" headhunting" service( these can be pricey) .
Dental schools are also an option, but if you need someone who can hit the ground running from a production standpoint, this may not be the best option as you may have to deal with a learning curve. - the fifth question is: "how does the associate' s treatment philosophy match up with yours? " let' s say you' ve worked out the need for an associate, what the level of compensation is, the job description and the hours that he or she will work. Just keep in mind that if you outflow enough, you' ll eventually find someone who will be a good fit. You also searched for an associate and are now interviewing an associate prospect. Divergent treatment philosophies between a senior doctor and his or her associate is the cause of more turmoil than you' d suspect. He or she seems like a nice person but what is his or her treatment philosophy?
How can you prevent this in lieu of having to work together for six or more months? - now, ask the associate to draw up a treatment plan based on the information to hand. Try this approach: During the interview with your prospective associate, along with accompanying, take ten charts x - rays, models( if there are any) and temporarily remove the treatment plans. Match up the associate' s treatment plan with the treatment plan you made for the case. You could also describe a number of clinical scenarios and see what course of action he or she would take and see how that agrees with what you might do. If they are relatively the same, you may have a good match.
Ultimately, the MOST important thing to consider with an associate is their level of clinical competence. - there are a couple of things you can do to get an idea of where they are at clinically. You may not be able to establish this for yourself without working with him or her. They could treat you. (Even if it is a prophy, you' ll see their chairside manner and the like. ) You could have them bring in models and pictures for cases they have completed. If you feel you have found the right candidate, you could possible have them treat you and some of your staff. Other than that, you' ll have to check up on their work with your patients. If the team isn' t sold on them as a clinician they' ll be reluctant to have patients see the' new guy/ girl' .
I once had a doctor tell me that there was no way he would let his associate work on him. - you' ll end up just as busy as you are now while paying the associate to sit around because" none of the patients wants to see the associate. " it may be a great ego - trip to a have an associate but if it doesn' t move you in the direction of lightening your load or expanding the practice, it' s not worth it. Excuse me? Their treatment is your treatment! They represent your office. You are responsible for their work. These are a few of my thoughts on a subject that could easily fill a book.
And no one wants to be re - doing dentistry for free after a sub par clinician leaves the practice, not to mention the effect this has on your patients and practice. - try these simple guidelines and get good advice from your advisors. Choose wisely. In the end, the decision ultimately is YOURS. If you would like to get more information on this subject, or on how to get more fee - for - service new patients to keep your practice healthy, to expand or to make it possible to add an associate the" New Patient Workshop" from MGE( http: //www. mgeonline. com) is the solution.
