Wednesday, October 22, 2014

Associate Pay: Collections vs Production


Money Tree
This debate will exist forever. Associates want to be paid on production. Practices want to pay associates on collections. Associates say “Not my responsibility to collect money on production” or “I don’t manage the front office staff.” Practices say “can’t pay what we don’t collect” or “What if associate over-produces in order to make more money?”

It’s simple to understand and agree with either side of the argument. I have this same conversation with prospective associates and practice owners daily.

Collections pay is my preference in most cases involving FFS, PPO, and some Medicaid practices. I prefer to avoid DHMO practices since associates are better off being paid a salary rather than a percentage in those models.




Why Use Collections Based Pay?

  1. It is in the best business interest of the practice to collect all co-pays up front and bill insurance immediately. If the practice doesn’t do this effectively, the associate relationship will fail regardless of compensation method. Practices can’t keep paying bills if they don’t have the cash to do it.
  2. Production pay in most cases is “Adjusted Production.” Adjusted production is pay based on what the practice anticipates it will collect on a procedure based on the patient’s insurance plan. 
    1. UCR may be $1,000 for that crown, but since patient x is an ABC PPO patient, the crown production is actually $800. Production $800. At 30% associate earns $240.
    2. Let’s assume that crown doesn’t get covered, and the practice has to attempt to collect from the patient. After 90 or 120 days the crown fee is written off. A lot of practices will come back and deduct that $240 from a future paycheck.
  3. Based on the above, I would rather know that I am paid with money I keep and don’t have a chance of losing at a future date.
  4. Using a base guaranteed salary or a minimum draw will help with the initial employment period of 3 to 6 months to get the associate started. If the collections are not above the draw in that timeframe, there are problems with the practice systems, and likely not a place an associate will want to work. 

    Side By Side Comparisons
Collections
Production
Associate paid when practice is paid Associate is paid at time of completed procedure regardless if practice collects patient/insurance payment
Practice can cash flow collections with payroll Practice likely has a deficit for a period of time between payroll and insurance/patient payment
Adjustments are made before associate is paid therefore greatly limiting future payroll adjustments Associate is paid up front, but the practice will adjust future payroll for uncollected payments ( isn’t this “collections” pay, just delayed for the practice?)
Associate often questions or wants proof that money is being collected by practice Associate feels more secure in knowing he/she is paid for work when it is done
Simple accounting cash in, cash out Accounting more challenging. Adjusted production usually means the practice will want to recoup payroll paid on uncollected procedures at a later date. Lots of tracking involved.
If practice collection percentage drops too low then associate will leave Theoretically, associate should be paid regardless if the practice is paid. If practice can’t collect practice would wind up terminating associate because it couldn’t afford associate
Collections based pay will better prepare associate for future ownership or partnership where he/she will live or die by cash flow Production based pay can build an unrealistic view of associates abilities in actual revenue

Stats and Red Flags
  • In most cases looking for collections percentage above 97%; anything out of the 90’s is no good
  • Practice has to open the books to the associate so he/she can see production/collection numbers. If practice is not willing to do this then the associate should move on
  • As in everything, communication is vital to everyone's success. Without communication all is lost
  • Associate needs to be educated and understand dental insurance, collection policies, timeline of collections, write-offs, etc
  • Practice should been willing to give an initial base minimum to build a mutual commitment
Written by Carl Guthrie, Senior Account Executive/Dental Recruiter at ETS Dental. For more information, contact Carl directly at 540-491-9104 or cguthrie@etsdental.com

Thursday, October 9, 2014

Marketable Clinical Skills - How Do you Compare?

What does it take to stand out from the crowd? What CE should you take to make yourself a more marketable candidate in the dentist job market?

Many factors play a role in a practice owner’s hiring decision. Matching treatment philosophies, goal alignment, communication skills, and personality compatibility all play a role. When an owner is comparing otherwise similar associate candidates, clinical skills will always be a major consideration. So how do you stack up?

Our firm, ETS Dental, is in a unique position to answer that. With over 9,500 general dentist interviews logged into our database, we are able to create a profile of the clinic skills self-reported by the average associate dentist candidate. Here is what we found.

Endodontics
Rotary Trained 84%
Comfortable with 1st Molars (uppers or lowers) 68%
Comfortable with 2nd Molars (uppers or lowers) 45%

Extractions
Comfortable with Surgical Extractions 79%
Comfortable Extracting Soft Tissue Impactions 46%
Comfortable Extracting Partial Bony Impactions 28%
Comfortable Extracting Full Bony Impactions 8%

Prosthodontics
Crown and Bridge 95%
Removable 93%
Veneers 65%

Pediatric Dentistry
Will only see adult patients 8%
Would limit their work with children 13%

Implants
Places Implants 15%
Restores Implants 73%


Additionally, we found that an associate candidate’s flexibility can increase the number of options available.

Saturdays
Would work some Saturdays 42%

Practice Environment
Would work in a corporate practice 41%
Would work in a Medicaid Clinic 23%
Would work in a Public Health Office 27%
Would work in Medicaid or Public Health 33%

While these results are self-reported and not scientific, they give a good overview of the clinical skills available in the associate dentist job market. It is our hope that this information will be helpful to you as you plan your next career move.

Written by Vice President and Senior Account Executive/Dental Recruiter Morgan Pace. For more information, contact Morgan directly at 540-491-9102 or mpace@etsdental.com

Tuesday, September 30, 2014

Base Salary (AKA Minimum Guarantee) for Associate Dentists

Over the past ten years, base salaries for General Dentists seeking associateships have become more commonplace in response to an increasingly competitive dental job market. Several factors have played into this change, including the ever-growing level of student debt and increased presence of Dental Service Organizations (DSOs) in the industry. From a practice owner’s perspective, the practice can use the guaranteed minimum to say “we have the patients and potential production available - can you produce?” As such, there is a perceived financial security with a base salary.
Below are some common ways we’ve seen dental practices pay base premiums to its associates.


Common Ways Dental Practices Pay Base Minimums
  1. Daily/Monthly Draw on future commission : This structure is, by far, the most common method in dentistry. The practice will pay the associate dentist a fixed amount that will be deducted out of the associate’s future commission.
    1. Pro : the associate has greater security at the beginning because there is a cash flow.
    2. Con : if the associate does not produce/collect enough the practice cannot recoup the draw if the employment is terminated by either side.
    3. Most common example : $500 to $600 per day ($10,000 to $12,000 per month).

  2. Salary + bonus : This structure offers both sides more of a win/win at the early part of the relationship. The practice and associate agree to a set salary that is paid regardless of the associate’s production. The bonus is a carrot for achieving a higher level of production.
    1. Pro : Practice can pay based on what it expects associate will/should produce while offering a bonus if goal/expectations are exceeded.
    2. Con : Such as the draw, if the associate is underperforming the practice will lose money on the arrangement.
    3. Example : $10,000 month; Associate can bonus by being paid 15% of collections on anything exceeding $35,000 per month. Calculate monthly or quarterly.

  3. Salary only : As simple as it sounds. The Associate is paid a base salary. In most cases, a practice does this because it realizes there needs to be a lot of growth in the practice overall. It is more of an investment in the associate and potential of the practice. In many cases a practice and associate will agree at a future time to convert from salary to commission in order for the associate to be incentivized on their production.
    1. Pro : Great for a new grad that receives mentorship from a senior doctor. Allows the practice to secure an associate without making unrealistic claims to what an associate can earn on a commission plan.
    2. Con : if you don’t have an associate who sees the big picture, you can have an associate who doesn’t strive to grow in this position due to the lack of incentives, thus making a bonus option a great addition to the salary.
    3. Example : $120,000 per year.
Why should you offer a base minimum?
  • Excellent way for practice to back up their claims of available production and income potential
  • Offers initial short term security to associate by providing a minimum cash flow
  • Helps while production and patient base is built up by associate
  • Competition for talented dentists
  • Security for your practice by limiting associate turnover

Friday, September 5, 2014

Is Your Training Program Attracting or Detracting Candidates?

Every organization offers some degree of on-job training, at a minimum during the onboarding process, but the quality of a company's training program can have a direct impact on the level at which employees remain engaged and motivated. Simply put, your organization's training and development opportunities, or lack thereof, could mean the difference between employees that stay or leave. In this post-recession era where attracting and retaining candidates is critical, companies should be asking themselves, what separates their training programs from the competition?

Click to enlarge.

As the hiring outlook continues to improve, more candidates are on the move in search of better job opportunities. Surprisingly, salary is generally not the motivating factor. In fact, according to Badgeville, the #1 gamification and behavior management provider, their 2013 Employee Recognition survey found that 76 percent of employees chose opportunities for growth as one of the top reasons they would stay with an organization over financial motivators.

Here is some advice to companies looking to modernize their training programs:

Routinely take inventory of the materials and delivery methods
the company uses to facilitate training. Look for areas that can be improved or updated, and think of ways to make the process more efficient and engaging.

Consider if the company's training program is versatile enough
to accommodate different learning styles and generational preferences. Millennials may prefer a more interactive training experience, whereas Boomers may be satisfied with binders and paperwork.

Research new technologies
that can help breathe new life into your training program. If the company is predominately using classroom-style seminars, new hires could be checking out before the onboarding process is even over.

In today's job market which is candidate-driven in the executive, managerial and professional space, companies have to do everything they can to differentiate themselves from the competition. Discussing the unique aspects of your training program during the recruitment process could be the thing that sets your organization apart.


ETS Dental is a Dental Recruiting firm specializing in finding and placing General Dentists, Dental Specialists, and Dental Staff throughout the United States. www.etsdental.com

Wednesday, August 13, 2014

6 Tips to Ace a Video Interview

Video interviewing is quickly becoming a favorite medium for employers to connect with potential candidates. Knowing how to conduct or participate in a video interview and have everything go smoothly, however, takes some preparation.


Here are a few tips to help you do your best:

1. Make a Good Connection - Before you can make a good connection with an employer during an interview, you must first ensure that your internet connection is up to par. Conduct the interview somewhere where you will have a steady internet connection with decent speeds. Stuttering video, skipping audio, or worse, a connection that drops out altogether, are all symptoms of slow internet speeds and might cut your chances of acing the interview painfully short.

2. Location, Location, Location – Where you decide to set up your webcam and conduct the interview plays a huge role in the quality of your overall presentation. Try to choose a quiet area with sufficient lighting and make sure what’s behind you isn’t distracting to the interviewer. If you will be conducting the interview from home, make sure any fellow cohabitants are aware of what you’re doing and won’t have to enter the room during the interview. Having a spouse or roommate dash across the background is not only awkward for you and the interviewer, but comes across as unprofessional. Finally, don’t forget to secure all pets and children in another part of the house with supervision to avoid any additional distractions.

3. Test All Tech – Several days before the interview, test your webcam, microphone, and computer to ensure everything is working correctly. Familiarize yourself with volume controls and any settings that might improve the quality of your interview. If you’re purchasing a webcam for the first time, look for one with HD capabilities and a quality built-in microphone. Prices on webcams and microphones have become very reasonable in recent years, so spending a couple extra dollars to avoid grainy video and choppy audio during your interview will certainly pay off and give your presentation a professional flare.

4. Dress Your Best
– Although the interviewer will likely only see you from the waist up, dress in full professional attire as if you were meeting them in person. Opting for pajama pants in place of traditional garb may seem like a great idea, but you never know when you may have to stand up or retrieve something from the other side of the room that would reveal your entire outfit.

5. Don’t Interview from Work – It may seem tempting to interview from your office at work, but doing so communicates to your interviewer a lack of respect for your current employer. You also run the risk of a supervisor or fellow employee interrupting the interview, which can not only diminish your chances of landing the job, but cause conflict in your current employment situation.

6. Practice Truly Makes Perfect – Talking into a camera is very different than speaking with someone in person. Practice looking directly at the camera when you speak so that the interviewer can see your eyes. Try to avoid looking down at the screen or around the room when speaking, as doing so could communicate disinterest or disengagement from the task at hand.

As with any interview, prepare yourself ahead of time to answer questions in a concise manner that highlights your accomplishments and addresses how you would be of benefit to the employer. Although a Skype or FaceTime video interview can be very different from a traditional in-person meeting, following the tips outlined above can help make the process go smoothly and allow you to make a great first impression.


ETS Dental is a Dental Recruiting firm specializing in finding and placing General Dentists, Dental Specialists, and Dental Staff throughout the United States. www.etsdental.com