Finding An Associate- We're Your Tipping Point

Not news: There is a shortage of qualified Associates or potential Partners.

News: Strap yourself in, because we haven’t seen anything yet.

During the past 12 months, the ETS Dental team has made 107,000 calls and had more than 115,000 individual email correspondences with Dentist Candidates and Dental Practice Owners.

The result? While many industries were slogging through the “Great Recession,” we’ve found that outside of a few saturated Dental School cities, there are really no unemployed Dentists. From 1975 through 1986, Dental Schools graduated literally thousands of Dentists more than they have graduated over the past twelve years. Good economy or bad, this simply means that, over the next decade, there will be a steadily decreasing population of dentists per capita.

Certainly, there are those Dentists who would like to earn more money or find a better opportunity. However, as a group, Dentists are at full employment, and less are willing to make a change than in the past. In fact, we’re making 60% more recruiting contacts to generate the same number of applicants than just one year ago.

So, what does that mean to you? If you plan on looking for an Associate or potential Partner/ Buyer in the coming years, start you search sooner, rather than later. In the very near future, we will see a spike in demand and competition for Associates in the following groups:

Deferred Retirment Dentists: We’ve spoken with hundreds of Dentists who have deferred retirement for a few more years simply because their retirement funds shrank with the reversals in the stock and real estate markets.

Two things will happen with this group. As the stock market returns to where it was a few years ago, many will be in a position to transition out once they find a qualified heir apparent. A second group of “fire sale” practices will come available from Dentists who decided to continue practicing but had a sudden medical condition that forced them into retirement. Our team fields at least one call like this per week. If you currently have an Associate and have not worked out a buy-in/ out arrangement, do it now. Don’t lose a great Associate to an emergency practice sale in his/her spouse’s hometown.

Deferred Growth Plans- (2009 Dental Economics/ Levin Group Practice Survey, 10/09 Issue): We’ve spoken with hundreds of Practice Owners who reported they are planning to hire an Associate “when the news gets better.”

The truth is, that for many practices, the news is getting better. Although median annual gross practice production declined by 3.5% since last year, many practices are reporting that production is on the rise, but they are still standing on the sidelines. In the Dental Economics/ Levin Group practice survey, 39.5% of respondents
reported they increased their production over the past six months. More importantly, 43.9% said they are confident they will increase production over 2008.

Practice Management Companies- (Forbes, Susan Adams, 11/19/09): This week, Forbes published an article about accelerating growth of the National Dental chains. the author cited Aspen Dental, which opened 50 new offices this year and plans on opening another 50 in 2010. Practice management companies like Heartland, DentalOne and AllCare can also be expected to act aggressively.

Not-for-Profits: An unprecedented amount of funding is making its way to not-for-profit clinics around the country. Many not-for-profits that previously could not offer Dental services are taking advantage of grants to add Dental Clinics, and those with Dental services are expanding. Loan reimbursement funding for early career dentists (and other medical professionals) will grow dramatically. Many not-for-profits offer guaranteed salary plus eligibility for Dentists to qualify for Federal tuition loan reimbursement. This is especially appealing to recent Dental School Graduates with a huge student loan burden (often $200-$300k or more).

Summary: There currently is not a pool of unemployed Dentists to draw from when you are ready to hire. In the next year, practice owners will see a dramatic increase in the demand for new Associates from Deferred Retirement Dentists, Deferred Growth Practices, Practice Management Companies, and Not-for-Profit Clinics with newfound funding and huge patient demand. If you like your current Associate, take proactive steps to keep him/her today. If you plan on hiring an Associate, be ready to put your best foot forward.

Written by Mark Kennedy, Owner/ Director of ETS Dental
mkennedy@etsdental.com, http://www.etsdental.com/

Dental Staff- Making a Good First Impression

As a Dental Staff Recruiter, I have the privilege of speaking to hygienists, assistants, and office staff around the company and at various points in their career. It is my job to make a positive match, finding the perfect fit for both the candidate and the hiring practice. However, after five years in the recruiting field, I have learned that the best possible candidate is not always the most educated, experienced, or decorated within the field. Sometimes, it just comes down personality and who makes the best impression. I know that sounds trivial, but we are in the people business-ETS, as recruiters, and you, as a dental professional-that being said, the old adage “You never get a second chance to make a first impression” really holds true.

Remember your phone screenings are part of the interview process; this holds true with your conversations with the recruiter and with the practice. Give the phone call your undivided attention! Move away from the screaming children. Find a spot in the house with decent reception. Sell yourself-elaborate on your resume! Tell us why YOU are the candidate we have been looking for! However, there is a fine line between confident and cocky, so don’t overdo it!
Also, early on in your search, take a look at how the outside world views you. Google your name and see what “pops up”. Those blog entries from high school may still be out there! Take a minute to review your social networking sites-do you want your prospective employer to see what is posted? You will also want to consider your phone’s ring back tone-my personal pet peeve. Do you want their first impression of you to be a Nickelback or Buckcherry song? I think not. Also, listen to your voicemail! When you are searching for a position, it is not the best time to place a commentary on last night’s game on your message nor is it professional to have a “You know what to do” message-be professional.

Now is an exciting time to be a job seeker and the market only continues to get stronger. It is time to put the years of education and preparation to work. By putting your best foot forward, hopefully you will land that position you are looking for!

Posted by Tiffany Worstell, Dental Staff Recruiter at ETS Dental. You can reach Tiffany at (540) 491-9112 or tworstell@etsdental.com.

Resources for those entering the dentist job market

Here are a few helpful resources for graduating dental students, residents or dentist ending their military commission. For more up to date tips and helpful information follow up on our facebook fan page, twitter, or on our blog.

How much will I make: Data from 2009 Levin Group/Dental Economic Survey (.pdf)

Where do I look for a job: ETS Dental Position Search, Indeed.com job listing aggregator, Careerbuilder.com, DentalTown Classifieds

What should I know going into my job search: Job seeker tips

Traditional Practice or Group Practice: Which is right for you?

Where do I want to live: Area reports and comparisons

How do I write a CV: CV writing tips or email mpace@etsdental.com for a link to ETS Dental’s CV wizard (beta).

What should a dentist cover letter contain: Cover letter sample, Writing a Cover letter

How should I prepare for an interview: Interview tips and questions and What hiring practices are looking for in a candidate

What should I look for in a dental contract: Questions to answer before accepting a job, Employment Contracts - What a New Dentist Should Know and considering an associate position leading to partnership.

Considering starting a practice-

• Financial comparison or scratch start or purchasing: "The Art of the Deal” by Tim Giroux and "’Scratch’ start-up or purchase?" by Rich Seims, DDS


• Financing may not be as difficult to find as you think if you use lenders that understand dental practices: Matsco and Bank of America Practice Solutions.

Analysis of Today's Bureau of Labor Statistics (BLS) Report

An Analysis of Today's Bureau of Labor Statistics (BLS) Report

The full report can be seen here: http://www.bls.gov/news.release/empsit.htm.

In January of 2008--24 months ago--the U.S. labor market began losing jobs, which by January of this year was happening at a rate of nearly 800,000 per month. According to the Bureau of Labor Statistics as of this morning, that hemorrhaging has slowed to just 11,000 jobs in November or essentially nil. The unemployment rate also declined from 10.2 percent to 10 percent. The numbers for September and October were also revised to show a loss of 139,000 jobs in September from the previously reported 219,000, and October to 111,000 instead of 190,000. Since the start of the Great Recession in December 2007, the unemployment rate has risen from 4.9 percent and the total number of unemployed has swelled from 7.5 to 15.4 million people.
The unemployment rate for management, professional and related occupations has now fallen nearly a full point from its 5.5 percent peak four months ago, to 4.6 percent in November. The total number of unemployed professionals topped out then at just over 3 million people and has since dropped to 2.5 million. One of the top gaining job categories in November was administrative and support services which, after having been decimated over the last two years, added 86,900 jobs during the month, with 52,400 of those coming from temporary help services. Overall, professional and business services added 86,000 jobs, and for the first time in years, beat out education and health services (+40,000) as the top jobs gainer.
After two years of job losses, today's virtually flat numbers are good, but they are still tempered by the 15 million people who remain unemployed and the millions more under-employed. Should the current number of people out of work continue for an extended period of time, there will remain the threat of a double-dip recession dragged down by sluggish consumer spending. However, many signs show that both job creation and underemployment are at last on the mend. The total number of part-time workers fell in November by 104,000, while the number of full-time workers rose by 140,000. The average workweek also added two-tenths of an hour after having lost eight-tenths since the beginning of the recession. Average weekly earnings surged to a high of $630.14, $10.18 more than in October and $10.06 more than the figure's last peak one year ago.

Questions To Answer Before Accepting a Job Offer

The New Year is an excellent time to start looking for positions whether you are finishing dental school, a residency or after ending your commission as a military dentist. After you write an impressive CV, line up interviews and begin to field offers, it is important to know what questions you need to be asking. Here is a compilation of questions from job seekers that I have worked with over the years. I hope that you find it helpful.

Relationship
-Employee or Independent Contractor?
-Employee at will?
-Is the doctor open to restrictive covenant in case of future ownership?
-Is the doctor going to stay on PT for some time or can he, if needed (After purchase)?

Schedule
-Days, hours, on call, etc.
-How many office hours and days per week is the office open?

Type of Practice
-How the practice is set up (family, Pedo, or dentures)? Pedo: what age?
-Age of the practice?
-When/what do you refer out?
-Place or Restore Implants? Which system?
-# of operatories
-# of Hygienists. Hrs of operation?
-# assistants
-Will the associate have their own assistant?
-How much is the practice overhead?
-How long has each employee been there?
-What does the practice do to market itself?
-How many FT and PT staff?

Patients
-What is the patient pool like?
-Have the number of active patient records been reviewed?
-Is the practice growing or declining in number of patients seen, new patients -attracted, and young patients?
-Average number of cancellations per week?
-Average number of patients seen by associate per day?
-How far ahead is the doctor book filled?
-How far ahead is the associate book filled?
-How far ahead is the hygienist’s book filled?

Duties
-Job description (separate document) or general description
-Is the associate expected to check hygiene of other doctor’s patients? If yes, will the associate be compensated for it?
-Will the associate be expected to perform hygiene/prophy?
-Does the doctor do any procedures other than regular general dentistry?
-What were the most of the cases being done by the associate?
-Will the associate be placing Implants for the practice?

Facilities
-Supplies, equipment, support. Etc
-What type of PMS (Software) is used?
-Implant surgical set up? Who finance to get that set up if NOT already have?
-What is the square footage of the office? Can it be expanded?
-Average age of equipment?
-Is the practice left-handed, right-handed, or ambidextrous?

Fees for service
-Appropriate/assign billing?
-Discounts/Bartering/payment plans
-PPO type of insurance? Insurances: accept all kinds or just selected ones?
-How much is the discounted price of the PPO compared to the fee schedule?
-Medicare or Medicaid acceptance?
-How much of the practice relies upon capitation programs, PPOs, HMOs, Medicare or Medicaid?
-What percent is FFS, cash and discounted PPO?
-When was the last fee increase?
-Are the fees low, high or average for the immediate area?
-Do you offer patients credit?

Term of contract
-How long?

Compensation
-Salary, Hourly, Draw, Minimum, Commission, Percentage, Bonus, When, How,
-Taxes withheld?
-What percent of production or collection will be the compensation?
-How will the associate be paid? (Weekly/bi-weekly/monthly)
-How much on average was the associate making?

Collection/Production
-Define
-What is the % of collection for the practice?
-What was the average associate production per day?
-Does the associate production include hygiene exams and x-rays?
-Can I get a fee schedule of the practice?

Benefits
-Medical Insurance: health and dental?
-Malpractice insurance?
-Disabilities insurance?
-Required CE courses? How much and for how many hours a year? Are they paid for/reimbursed,? Is there a stipend?
-Retirement?
-Sick days…….. # allow per yr…..
-Personal days/vacations…..# per yr allow……
-Holidays?
-What benefits are given to the staff?

Expenses
-Define, list, when paid, lab, etc…..
-What Lab do you use? Use different lab for different lab orders??
-Is the associate responsible for my own lab fees and expenses?
-Will the practice support the acquisition loan (in case of future ownership), pay the overhead expenses and afford a reasonable income?

Other Questions and Notes:
-What is your practice Philosophy and Goals? For the Practice and with new pt’s tx?
-% of implant surgeries
-Have you had associate before? How many? How long they stayed? What was the reason for the associate resignation?
-Do you have a confirmation system for apts?
-How do you deal with NO Show?
-Digital X-ray?
-Intraoral Digital Camera?
-How do you advertise?
-Will most dental insurance dictate pt’s Tx plan??
-Do you deal a lot with EMERGENCY pt? Separate operatories for that?
-Average number of emergencies per week?
-Will I be doing hygiene/prophy when I don’t have pt?
-Who determine how long I have when spending with new pt/initial exam and record?
-Do I have an apt separate to do comprehensive exams and record…. Or do I do the TP when pt come in for cleaning?
-How long does a hygienist spend on their recalls?
-Is there a particular doctor in the area who is your main competitor?
-Who sees the patient first (Doctor, hygienist, associate)?
-Why was the partnership offer turned down by an associate (if applicable)?
-Will I be able to visit the office during regular working hours?
-Does the doctor have a report showing how much treatment is treatment planned?

Partnership/Buy in/Sale
-Discussion/Formula/Price
-What will be the time frame for associate position before we can talk about partnership/buy in/buy out?
-Is there an option for future ownership? Are you considering a move out of state?

Licensure
-State, specialty

Confidential Information
-Define

Covenant not to compete
-Define

Termination of agreement
-Define

Disability
-Define, temporary, permanent, etc…..

Binding Effect
-Define

Amendments
-Define

Notices
-Verbal, written, witness?

Benefit and Assignability
-Define

Alternate Dispute Resolution
-Included? Define

Indemnification
-Define

Professional Conduct:
-Standards or ADA, MDA? Other
-Emphasis on Dr. name or practice name?


Provided by Morgan Pace, ETS Dental

Tags: Job Interview Questions What To Ask Associate Position Job Search Job

Dental Economics-Dental News - Part 2, 2009 Dental Economics®/Levin Group Practice Survey

Dental Economics-Dental News - Part 2, 2009 Dental Economics®/Levin Group Practice Survey

November 23, 2009

For more on this topic, go to www.dentaleconomics.com and search using the following key words: Dr. Roger Levin, annual practice survey, procedure mix, practice overhead, staff wages, practice production, stress, doctor satisfaction, economy.

As 2009 draws to a close, it's time to look back at the year's successes and challenges. How did your practice fare in this tough economic environment? Were you able to adapt and discover new opportunities? Or were you playing “catch–up” for most of the year?

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Complete Survey Here