Associate buy-ins are a hot topic of conversation. But, frequently, dentists find themselves making several attempts before successfully finding an associate who meets their needs and who they are willing to consider as a future partner. Through the years, I have noted the most common reasons why associateships fail:
Battle of the generations- The average age difference between the senior dentist and the associate is between 18 and 22 years. This difference means the two doctors come from two totally different perspectives. They were trained differently and, in short, have a different world view. These differences can be too great to overcome.
Lack of an ownership mentality - One complaint we hear about associates is they don’t look at problems in the practice as the owner does. This should be no surprise as very few dentists spend time teaching associates about the responsibilities of being an owner. Most associates would really like their employers to mentor them on management issues. However, owners worry that if they teach their associates how to run the practice, they risk losing them. The way to groom associates for eventual ownership is to take the time to teach them.
Not enough patients- In our experience, a practice should have a minimum of 2,000 active patients and be growing by 15 percent per year before it considers bringing in a second doctor. An active patient is one who has received a service from the practice in the past 14 months and has not died or moved away. Frequently, we see practitioners that are slightly busier than they want to be and they add an associate. Once the associate is on board, the schedule may ease off. If there aren’t enough patients, eventually both doctors have difficulty filling their schedules. If this lasts for an extended period, the owner begins to make less and problems arise.
Inability of the senior dentist to share the sandbox- Most dentists practice alone because that’s the way they prefer it. This is not a character flaw, but rather a fact of life. While most dentists think they would enjoy the professional companionship of having another doctor in the practice, many don’t enjoy the experience once the new doctor is hired. It is not easy to share patients, decisions about operations, and personal space.
Failure of the associate to build the practice- As I mentioned, associates often are brought in before there are enough patients to support both doctors. Prior to the associateship, the senior dentist may not have needed to focus on developing new patients. Once an associate is hired, the need for new patients increases and the senior dentist expects the associate to take action to help build the practice. Unfortunately, few young dentists understand the process of bringing in new patients.
Staff conflicts- Often, the problems between the doctors are centered around the staff. Sometimes, especially when the associate brings new ideas to the practice, employees do not like the change or extra work of having a second doctor in the practice.
Failure to discuss expectations - Many dentists expect their associates to be mind readers. Prior to bringing in an associate, think about your expectations. Once you have developed them, share them with your prospective associate. I recommend the employer-dentist develop a first year curriculum to judge the performance of the associate in a variety of areas.
No clear goal as to buy-in- Today’s associates are not willing to wait for years without the chance of becoming an owner. On average, we see a strong desire among young graduates to purchase a practice within three years of graduation from dental school. If you are convinced that this is not the right partner for you - or if you have no desire to have a partner ever - it is essential that you disclose this to your associate early on. It is reasonable to have the associate work for you for 12 to 18 months before making your decision, but at some point, you owe this person a decision.
Unexpected events - Despite our best planning, things happen that change the course for the employer or the associate. These things can range from family illness or the health or marital status of either of the parties, or any number of life-changing events.
Communication- The most important thing you can do to improve the chances for a successful associateship is to establish a system of communication. I recommend the employer and associate meet weekly for an informal lunch and once per month in an official meeting to discuss the associate’s progress and the state of the practice.
Theodore C. Schumann, CPA, CFP®, is president of The DBS Companies and past president of American Dental Sales. The DBS Companies service the financial needs of the dental community, in addition to representing American Dental Sales in Michigan. Contact Schumann by phone at (800) 327-2377, or via e-mail at [email protected].
