The Practicon Viewpoint by Ann Page Griffin

SCRATCHING YOUR HEAD ABOUT WHETHER OR NOT TO HIRE AN ASSOCIATE?

Should I hire an associate? This can be one of the most difficult decisions a practicing dentist faces. Numerous concerns may surface as one considers the positives or negatives of adding another dentist to the practice. The dentist may wonder:

• Do I need/want an associate because an occasional day of "over-busyness" is frustrating?
• Would changes to the schedule or the addition of another hygienist suffice?
• If I do decide to bring in an associate, can I find a person who is right for the practice?
• Will our personalities and personal styles mesh or clash?
• Will treatment philosophies and modalities be compatible?
• How will the associate be compensated? a daily rate? a percent of production? of collections?

And on and on.

Specific questions about practice systems must be answered as well:

• Is the patient load sufficient to support another dentist (general rule of thumb: 2,500-3,000 patients in a typical general practice, 4,000-4,500 in a pediatric practice)?
• Is the recare system 75% to 80% effective (i.e., do at least 3⁄4 of our active patients return regularly for hygiene care)?
• Is our show rate (percentage of appointments kept as made) 85% or higher?
• Is our case acceptance rate at least 85% to 90%?
• Is our collection percentage rate 97% or better?
• Are restorative appointments booked out more than six weeks? (Note: giving a patient a series of appointments prevents analysis of scheduling delays because it fills the schedule to the detriment of appointing individuals in a timely way. Make one appointment only at the end of each appointment. Additionally, studies have shown that patients, lay people who do not understand sequencing of appointments, are more likely to break appointments if they know they have another.)
• Must additional staff be hired to support another dentist?
• Will the office have to be expanded to accommodate another dentist? additional operatories? more reception space? more parking? What is the cost of adding space?
• How will patients be distributed? Who will see new exams? Will patients be assigned to one dentist or shared?
• Will current practice overhead increase significantly to cover the expense of adding an associate? Consider potential increases such as additional staff, extra equipment, more instruments, more supplies, associate's wages and benefits, etc.

Typically, the addition of an associate is a financial drain on the practice for six to twelve months. By the second year, the senior dentist should experience at least 10% profit on the associate's production. In subsequent years, the associate should be producing a minimum of approximately three times her/his compensation.

There are many advantages to having an associate; for example, sharing the daily stresses of practice, professional collaboration, and spreading overhead costs between two or more practitioners. Furthermore, an associate allows use of the office over more and longer days and, potentially, means fewer emergency calls and more time off for each dentist.

Conversely, unforeseen problems between the senior dentist and the associate might surface after actually practicing together for a few months. That makes it vitally important to seek advice of the practice accountant, attorney, and management consultant as you consider hiring an associate. Finally, have your attorney write the employment contract so that all your bases are covered should a split occur.

Interview carefully and talk more than one time to each reference given by a potential associate. Talk with dental school faculty who knew the person during his/her training and with other dentists who have practiced with the candidate in former locations. And remember, no matter how perfect the match may seem on paper, the feelings, perceptions, and vibes you pick up when talking with a prospective associate are most telling and vitally important. "Trust your gut!" may be a crude expression, but it is a valuable tool in making this all-important decision.