Associateship: Can you make it work?

Laura Barres, DDS

What makes new dentists look for an associate position in an established practice? For some, it’s financial. In other words, their student loans are overwhelming. For others, it’s a “try before you buy” opportunity. Last and certainly not least, it can be a chance to gain more clinical experience while being mentored by an experienced dentist.

The key to knowing if you can make it work is knowing why the hiring dentist wants an associate and why the associate wants the position.

With so many clinicians at different phases of their careers, motivations can vary. Some look to an associate to relieve excessive patient load; some to build patient flow for a future buy in; and some to help prepare for retirement. Some hiring dentists have personal interests, such as wanting to provide coverage for when they cannot be in the office, or hopes that the new dentist will grow their practice.

Potential pitfalls

While intentions of both parties are usually good, things can still turn sour if communication is not effective. Some of the more common reasons for the relationship not to work include incompatible philosophies of practice; inability to support an additional dentist; unrealistic expectations for time, compensation, or both; and owner dentist unwillingness to relinquish control.1

Potential fixes

At the end of the day, the greatest fix is a written contract. Let’s face it, as in every relationship, we are all most open-minded in the beginning. Putting the agreement in writing maximizes the honeymoon period and minimizes the chance of future misunderstanding and disagreement.

Speaking as a young dentist, I know that a key point of interest is what we’ll focus on next—it’s just reality.

Compensation

Paid on percentage:Love it or hate it, the current typical range for compensation is 25% to 35% of the associate’s production or collection. Many dentists also get minimum guaranteed annual compensation. This is a mutually beneficial scenario for both the associate and the owning dentist, as there is incentive for the associate to produce. It also allows the owning dentist the ability to plan financially for the associate’s salary.2 Many times the issue of who should pay the lab bill presents itself in this compensation method. A simple way to solve this is to have the bills removed from the production or collection figures prior to the final compensation being calculated.1

Paid on salary:Another common approach, salaries can be an hourly, daily, or monthly base pay. Many young dentists like the security of salary-based compensation. This allows for financial planning and the security of knowing how much money to budget. With the national average student loan debt being $287,331,3the payment plans terrify many students and make the prospect of a guaranteed salary very appealing. On the other hand, you usually do not make as much money with this compensation plan. Consider if you can handle the risk of having a bad month, or if you are willing to give up the potential earnings of percentage-based compensation for the security of a salary.

Paid on a draw:While a less common method of earning, being paid on a draw means being paid expected future earnings. This can also be explained as a loan against projected income. If the associate’s percentage collection or production is less than the agreed amount of the salary, the office will cover the difference in the associate’s pay. The net of what the associate has earned minus what the associate has been paid will then be settled as the end of a set amount of time.2 In this scenario it is possible for the associate to owe the owning dentist money at different points in time.

Conclusion

In the end, there are many important considerations when it comes to answering the question of whether you can make it work.Know your why. Know your counterpart’s why. Build a contract on the front end that maximizes everyone’s success and minimizes everyone’s risk. Oh, and don’t forget the compensation. It may be the dirty little secret no one wants to talk about—but it’s a deal maker or a deal breaker.

References

1. Bickers C. Associateships – Everything you need to know. Dental Entrepreneur website. http://www.dentalentrepreneur.com/associateships-everything-you-need-to-know/.

2. Dentist contract negotiations – Compensation considerations. ETS Dental website. https://www.etsdental.com/resources/blog/dentist-contract-negotiations-compensation-considerations/. Published March 3, 2016.

3. Educational debt. American Dental Education website. http://www.adea.org/GoDental/Money_Matters/Educational_Debt.aspx#sthash.W0AXsps0.dpbs.

Laura Barres, DDS, graduated with honors from the University at Buffalo School of Dental Medicine, minoring in prosthodontics and pediatric dentistry. Dr. Barres completed her residency at Yale-New Haven Hospital, gaining experience is all aspects of patient care. Her research in oral biology has been published in multiple journals and presented at several national conferences. She currently practices in East Amherst, New York.