New associates

April 1, 2002
The success of any associateship or partnership largely depends on the acceptance of this new member of the practice by the entire dental team.

By Linda L. Miles, CSP, CMC

The success of any associateship or partnership largely depends on the acceptance of this new member of the practice by the entire dental team. Formerly happy, well-organized solo practices can go through tumultuous changes that can play havoc on anticipated growth. Unknowingly and most often unintentionally, breakdown of these relationships becomes apparent before the ink dries on many of the agreements.

The dentist's view – My associate has been here for a year. I would have thought by now that he would be more productive. My overhead is up, my stress has increased, and I'm not sure this is working.

The staff's view – We liked our practice the way it was before. Now we have to give up our Fridays off, our patients are loyal to our senior doctor, and frankly, we wish we could be a happy work family without this added stress.

An associate needs the full support of the senior dentist and the staff to become a passive income center. He or she must be introduced properly to patients and staff. Sitting down to discuss why the practice is bringing in a second dentist is key to the long-term success of the arrangement. What will the benefits be for the patients and the practice? How will the senior dentist and staff benefit from having an associate? Until these questions are answered, the relationship is doomed.

The senior dentist should explain to the team: "Thanks to your dedication and hard work, we have built a patient base that requires another dentist. The benefit to the patients will be additional available appointments and services. The benefit to the practice will be higher revenues if we support this new dentist in developing a highly successful two-doctor practice. The benefit to me is that there will be someone to cover for me on days when I am not here. I will have a colleague to consult with on patient and management issues, and there will be increased net profit for the practice through increased revenues. The benefit for you is additional room for growth in your compensation packages as the practice develops."

The associate's ability to produce more revenue depends on scheduling, staffing, and support issues. If the team and senior dentist have second thoughts or wish they could go back to "the way things were,"the associate will probably look for opportunities elsewhere.

The dentist's view – My associate makes herself "one of the staff."She goes to lunch with them and never consults with me about practice issues. I wonder whose side she's on. I feel like the "odd man out."I thought bringing an associate into the practice would be a plus.

The staff's view – Our senior dentist acts jealous of the relationship we have with our new associate, Dr. Karen. He gets angry if he sees one of his patients on her schedule. We are caught in the middle. Why did we bring this second dentist into the practice if, in fact, our senior dentist can't share the patients and be happy that we like her?

One of the major problems with interpersonal relationships in a two-doctor practice is that the second dentist typically is closer in age to the staff. The staff often confides in the younger dentist and shares their complaints about the practice or the senior doctor. This can be the kiss of death to the two doctors' relationship. While it is OK to go to lunch occasionally with the team, a hard and fast rule must prevail: If the conversation turns into a gripe session, the associate must let the staff know that while he or she understands the concerns, it is totally unfair for the associate to discuss the senior dentist's faults with them. The associate should offer to arrange a three-way meeting with both doctors and the staff to discuss the issues fairly. Likewise, the senior doctor should never discuss the associate's faults with team members. Practice problems need to be aired in a group situation, and personal intervention should take place privately.

Linda Miles, founder and CEO of the dental-management consulting firm Miles & Associates, has spent four decades as a dental employee and employer. She instinctively resolves sensitive issues in dental practices that ultimately become triple wins – for the dentist, the staff, and the patients. She believes that happy employees perform at far higher levels than those with hidden issues that are only discussed at lunch without the dentist present. Her third-party, experienced-based opinions are not pro-doctor or pro-staff, but always pro-practice. You may contact Ms. Miles at (800) 922-0866, [email protected], or visit

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