Can your Dental Practice Support an Additional Dentist as an Associate or Partner?

All to often I speak with practice owners that say they would like to add an associate dentist, but after speaking to them I find that they lack the revenues, patient base, or planning to really make this happen. First and foremost, as a practice owner, you have to ask the question, "Why do I want/need an associate?"

Reasons I often hear are: "I am much to busy to keep up with the demand on my practice." "It is time I start transitioning ownership over the next 3+ years." "I want to work less." These are decent starts, but you have to take a look at several other factors.

Is the practice productive enough with one doctor?

You need to determine the number of truly active patients in the practice. A single practitioner needs at least 1500 active patients over 12 to 18 months. You also need to be grossing at a minimum $750,000 annually. Also, considers the types of cases. If your cases are generally very large producers then you patient count may be lower. Bringing on an associate dentist if you practice is doing less than the following will most likely cost you, the practice owner, money. Not make more.

Do you have enough patients for a new doctor?

You need to plan on several things in order to ensure your new associate will be busy and productive. You need to have at an excellent new patient flow. You are most likely not willing to give up your own active patients. That cost you. Marketing, is going to have to be addressed. If you only get 15 to 20 new patients per month you will have to step up the efforts to get more so your associate can work. Take a look at inactive patient records as well, and see what you can do to reach out to them, and get them back.

Do you have enough space?

How many ops do you need on the days that you work?  Do you have op(s) for your hygienist(s)?  If you are working in all of the operatories then where will this associate work?  Space is cruicial to having a successful and committed associate.

What do you normally refer out?

If you are referring out molar endo, oral surgery, or implants you should target associates that can add more value to your practice. Associates with the ability to do these procedures in your practice simply adds to your bottom line. More and more practices are taking this approach. NOTE: if you are looking to add an associate with these skills then you will have to be willing to invest in the necessary instruments and equipment required.

Is this your exit strategy?

If you are hiring an associate with the goal of transitioning out then you need a detailed, written plan for what will happen and when. Talk about these thing up front with candidates. Show them the plan. This allows the potential associate to know what is expected. Let the associate have input, and expect negotiation.

Do you know what Associate Dentist expect to be paid?

You have been in practice for 20+ years. You were paid $70,000 a year as an associate when you first graduated Dental School. Associates candidates now making around $120,000 in a good private practice associateship.

All in all you have to plan well ahead and make sure this will benefit you, your practice, and your associate.

Advice to 3rd & Rising 4th Year Dental Students

For me, the end of the summer is always marked by three things- the start of college football practice, back to school sales, and daily calls and emails from Dental Students wanting to get the jump on their job search. As one who always waited until the last minute to do projects or write papers in school, I admire those dental students that are acting so far in advance. Unfortunately, there is rarely anything that I can do except tell them to keep in touch until practices are ready to start interviewing, which is usually in the fall or spring of the year they graduate.

In the meantime, there are several things that D3s and D4s can do to better position themselves to get their dream jobs. I recently traded emails with a very proactive rising D3 who had some well thought out questions:

What can a D3 do to better position himself/herself to get a job after graduation?

Be active. Take part in activities that allow you to form relationships with doctors who live and work in the area where you want to settle after dental school. If possible, sit in on the local dental meetings. If your dental school allows you to work in outreach programs or to spend summers working in private practices, do so. Dental clubs and fraternities are also a good source to expand your network. Often the best opportunities are not those that are advertised in the local association newsletter. To get in on the best positions you have to know people or know people who know people. The larger your network, the better your chances of having the right contact. Of course, if you are not careful and you get a bad reputation, this will work against you. You should be careful to consider this when posting to Facebook or other social media outlets.

In competitive interviews, what distinguishes those who are offered the best positions?

Personality is very important but the most successful candidates are those who have done the most. That is to say, these dental students exceeded their minimum graduation requirements. Those that extracted hundreds of teeth on a mission trip or who finished their requirements early and took on additional training or who used their assigned patients to ask for referrals to additional patients are those that truly stood out and who had no problem lining up a good job after school. If you are a go-getter who takes your training seriously and who is willing to go above and beyond to land the implant or veneer case, you are exactly who a successful practice owner wants to hire.

How difficult is it to get financing these days?

Luckily, there are a few lenders who have programs designed specifically for dental practices. They know what to look for and so are in a position to loan money when a local back wouldn't understand the risks involved. Matsco (owned by Wells Fargo) and Bank of America are two that come to mind. I have had the best results with Matsco, but I understand that Bank of America is sometimes more flexible. A benefit of going through a dental-specific lender is that they have a support network in place. They offer business coaching, help you develop a business plan, and provide other resources. The funds available to you right out of school are not likely to be sufficient to allow you to open your own practice, but after 1-2 years of experience, you will have a much larger pool of funds to draw from.

What should I consider when deciding where to practice?

One of the biggest mistakes dental students make is trying to stick around in their dental school city. It is a matter of supply and demand. Dental school cities have far more competitive job markets and generally offer far lower long-term income potential as there are fewer patients per doctor. To a lesser extent, going to the big cities is also a bad idea. For instance, The Washington DC area attracts graduates from Howard, UMBC and VCU but is also a hot spot for dental school grads from all over the country. Atlanta, New York, Boston, Los Angeles, Chicago, San Francisco and Seattle are all very difficult job markets. With a bit of experience, these areas can be rewarding, but most dentists will always struggle to earn as much in the big cities as their classmates in other areas. When you factor in the cost of living, the disparity increases. Consider looking at second tier cities that often provide a high quality of life at a lower cost and with greater income potential.


Here are some other blogs with useful information to a dental student:

Joining a private practice vs. a group:
http://dentalrecruiterblog.blogspot.com/2010/07/traditional-practice-vs-group-practice.html

Words of wisdom from the Indianapolis Dental Society: http://dentalrecruiterblog.blogspot.com/2010/06/great-tips-and-words-of-wisdom-from.html

Job seeker tips for new graduates and residents: http://dentalrecruiterblog.blogspot.com/2010/06/job-seeker-tips-for-new-dental.html

What hiring practices are looking for:
http://dentalrecruiterblog.blogspot.com/2010/04/what-are-hiring-dental-practices.html

Cover letters:
http://dentalrecruiterblog.blogspot.com/2010/03/dentist-cover-letters.html

Landing the best associate position: http://dentalrecruiterblog.blogspot.com/2010/03/landing-best-associate-position-go.html

Interview Tips:
http://dentalrecruiterblog.blogspot.com/2010/02/associate-dentist-interview-tips.html

Resources for those entering the dental job market: http://dentalrecruiterblog.blogspot.com/2009/12/resources-for-those-entering-dentist.html



If you are a third of fourth year dental student or a recent graduate, I welcome your questions or insights.



Written by Morgan Pace, Recruiter/ Account Executive at ETS Dental. You can reach Morgan at (540)491-9102 or mpace@etsdental.com. Find out more at www.etsdental.com.