Why Associateships Fail
Roger P. Levin, DDS, MBA
Do you need to significantly increase your profits by helping your practice to grow? Do you want to limit your work hours and still practice dentistry and managing your business? Have you ever thought about doing the only initial examinations in your practice and transferring the specific procedures to a colleague? Do you want to decrease your workload as part of a lifestyle change or bring in someone as a future buyer of your practice? If you answered “yes” to any of these questions, then you may need to seriously consider bringing an associate into your practice.
Before you start asking around, placing employment advertisements, and calling recruiters, there is an important issue you should consider: many associateships fail, causing a significant amount of emotional stress and financial discomfort.
Why do many associateships fail? Since 1985, Levin Group has analyzed this question while working with the hundreds of dental practices that seek knowledge about associateships and partnerships. As a result of our analysis, we have compiled a list called “associateship deal breakers”.
Associateship Deal Breakers
Too Little Work
Analyze your practice. Is there enough work for both the dentist and an associate? All too often, the answer is “no”, yet many dentists still insist on acquiring an associate for all the wrong reasons. If there is enough work, then stuffy your current production and decide how the workload will be divided. At first, an associate will assist with your existing patients and share a portion of your revenues. Be aware that stress increases during this stage (when compensation decreases as a result of lower profits) so make sure there is enough production in the practice to provide sufficient income for both you and the associate.
Key personalities will have a major influence on how events unfold. That is why selecting the right associate dentist is essential. Should you and your associate fail to get along, the stressed relationship is sure to be a deal breaker.
When owners bring on an associate into their practices, they often expect the associate to think and act as they do. If this is your mindset, I urge you to reconsider. Instead of basing your vision of your new associate on who you are, base it on your vision of who you are not. Look for someone who complements your strengths and compensates for your weaknesses rather than someone who is a replica of yourself.
Take the time to make a “laundry list” of candidate requirements. Do your research by talking to colleagues who have associate dentists, then create a “wish list”. After you have completed your wish list, create a profile of your ideal candidate. Edit the profile by determining what is practical and what is not. For example, do you need someone who is extremely experienced in advanced services or some who can successfully present treatment plans and work well with a team? Make an evaluation sheet based on your edited profile. This sheet will become your checklist when you interview potential candidates. The most important thing is finding someone who is willing and able to share knowledge.
The Right Answers to the Wrong Questions
Many clinicians do not ask the right questions during interviews. Preparing interview questions before your initial meeting not only helps keep you focused, but also provides you with the opportunity to determine what information you really want to get from the candidate. When interviewing a potential associate dentist, there are two types of questions you should ask: clinical and managerial. Keep in mind that clinical questions are not designed to assess clinical skills. Rather, they are intended to provide information regarding the candidate’s level of experience, likes/dislikes, and comfort level with technology. Management questions are designed to find out how flexible and willing the candidate is to fit into a new practice. To determine the candidate’s areas of interest, the following questions may be beneficial during the initial interview:
“What are your views on quadrant dentistry?” The response to this question will tell you if the candidate’s philosophy is congruent with that held by your practice.
“What journals do you read on a regular basis?” The candidate’s response will indicate his or her specific areas of interest.
“What is the most recent clinical technology and/or equipment you have learned to use?” Follow up this question with other question. “How did you got about learning it? Did you teach anyone else after you learned?”
“Can you describe the most satisfying work experience you have encountered?” The response to this question will help you assess how satisfying your practice will be in comparison.
“Can you describe a success you have experienced? What qualities do you think contributed to your success?” Responses to these questions will tell you if the candidate’s definition and level of success is in accord with yours.
“Can you describe a failure? Why do you think it was a failure? What could you have done to prevent it?” While these questions are similar to the last questions, they will also tell you how much responsibility the candidate assumes for failures.
A Chaotic Practice
Get your practice in order before you hire an associate. Chaotic practices destroy associateships. Unfortunately, most dental practices are not systemized and do not operate properly. Despite the fact that a dental practice’s productivity and profitability may be soaring, its business systems may well be in shambles. Levin Group has found that adding an associate to a chaotic practice will only increase the level of chaos.
If you invest in an associate, you do not want to lose him or her because he or she sees no future in a poorly managed practice. An associate does not have the knowledge or experience to analyze business systems. In the first you (before becoming a partner), many associates are usually in a “testing” mode. More often than not, they simply want to practice dentistry and not manage the day-to-day operations. If an office has not incorporated easy-to-follow business systems, the associate will often leave the practice. If an associate wants to get involved with management from the beginning, however, allow him or her to slowly become a part of the process. Today’s associates have many options and will not remain in a poorly managed practice.
Lack of Respect
Ensure that your dental team treats the associate with respect. Dental teams often fail to give new associates the respect and deference they deserve, viewing them instead as intruders. To discourage this type of behavior by your team, make it clear from the beginning that the associate is to be treated with respect. While your team should be able to voice concerns about changes requested by an associate, the associate should feel free to bring his or her own style to the practice. When the team fails to respect the associate, you can be sure the associate will leave the practice.
Once you have chosen the best associate for your practice, it is the balance between coaching your associate and letting him or her develop a style of his or her own that yields positive associateship experiences. If you do not take the time to work directly with your associate on clinical and managerial issues, the associateship may still be doomed to fail.
While many practitioners have had associates who have worked out magnificently, others may not have been so fortunate. Before adding an associate, evaluate the above situations to best determine if they will affect your practice. Make any changes necessary, and consider having an attorney who is knowledgeable about dental practices draft an associateship agreement to protect your practice. According to the Levin group attorney, who has completed hundreds of associateship and partnership deals, there are many reasons why associateships fail. Most failures can, however, be avoided with the proper planning and the incorporation of key strategies.
*Founder and CEO, Levin Group, Baltimore, Maryland